Pharmacoeconomic efficacy of atesolizumab compared with other PD-1 inhibitors in patients with advanced non-small cell lung cancer after chemotherapy

Abstract

Aim: to evaluate the pharmacoeconomic efficacy of the application of the atesolizumab (PD-L1 inhibitor) preparation compared with other control point inhibitors (PD-1 inhibitors) in patients with advanced non-small cell lung cancer (NSCLC) after chemothe rapy.Materials and methods. Study design included a retrospective analysis of literature data and modeling. Based on the calculations conducted in a Microsoft Excel model, we analyzed the effect of minimizing costs on using comparable drugs with comparable efficacy; we evaluated how the provision of all patients with NSCLC will impact the health system budget taking into consideration the fact that all these patients are currently provided with PD-1 inhibitors in the second and third lines and with the atezolizumab preparation. For calculations, we used the prices stated in the state register of maximum selling prices; the weighted average maximum wholesale premium was calculated according to the Federal Antimonopoly Service (FAS). Results. In the analysis of cost minimization, atesolizumab proved itself to be highly clinically and economically effective. It allowed reducing the costs by 28.6% over 3 years compared with the use of nivolumab, and by 31.3% compared with the use of pembrolizumab in the second- and third-line NSCLC treatment regimen. Analysis of the impact on the budget showed that if all 848 patients currently receiving PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens had been initially provided with atesolizumab, this would have reduced the pressure on budget by 21.90% or 664.25 million rubles for 3 years.Conclusion. The use of the atesolizumab preparation is pharmacoeconomically reasonable and appropriate in comparison with the use of nivolumab and pembrolizumab. It will allow reducing the cost of PD-1/PD-L1 inhibitors in the second- and third-line NSCLC treatment regimens.