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Budget impact analysis of the use of lapatinib in the treatment of breast cancer in Italy

Farmeconomia

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Title Budget impact analysis of the use of lapatinib in the treatment of breast cancer in Italy
 
Creator Bamfi, Francesco
Basso, Federica
Aglietta, Massimo
Bengala, Carmelo
Lorusso, Vito
Pronzato, Paolo
Cavallo, Maria Caterina
Zaniolo, Orietta
Iannazzo, Sergio
 
Subject Pharmacoeconomics; Health economics
Lapatinib; Metastatic breast cancer; Budget impact model
 
Description Objective: to estimate the impact of lapatinib utilization within the Italian National Health Service (NHS) resources consumption. Lapatinib is an oral inhibitor of kinase protein, approved as dual therapy with capecitabine for the treatment of metastatic breast cancer patients with HER2 overexpression who experience disease progression despite trastuzumab treatment. Methods: the analysis is based on a model, which structure can be summarized as follows: a) national cancer registries-based estimate of the yearly number of HER2+ breast cancer patients who develop metastatic disease in Italy; b) literature-based identification of the rate of patients eligible to receive lapatinib; c) identification of the current therapeutic strategy-mix; d) costing of the alternatives, and e) calculation of budget impact. Direct NHS costs (drug acquisition and administration, and monitoring for 8 cycles of 21 days) are estimated based on current Italian prices and tariffs. Results: the annual number of patients eligible for lapatinib-based therapy can vary from 1,676 to 2,172, according to the expected extent of the trastuzumab use as adjuvant therapy. The current strategy-mix beyond progression is based on drugs used in the clinical practice, with a portion of patients continuing trastuzumab. Pharmaceutical cost of lapatinib results higher than the average cost of the current pattern of treatments. This cost increase would be partially offset by the reduction of laboratory tests and hospital personnel work for the oral administration of lapatinib, as compared to intravenous strategies. Furthermore, a risk sharing agreement has been adopted by NHS and manufacturer, according to which the NHS pays only for responding patients. As a consequence, lapatinib-based therapy would increase yearly NHS expenditure by about 3.8-4.9 millions of euro. Conclusions: lapatinib is the only treatment option specifically indicated for the management of HER2+, metastatic breast cancer in patients who received prior treatments including trastuzumab and is estimated to induce a low budget impact for the Italian NHS.
 
Publisher SEEd Medical Publishers
 
Contributor
 
Date 2009-03-15
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion

 
Format application/pdf
 
Identifier https://journals.edizioniseed.it/index.php/FE/article/view/161
10.7175/fe.v10i1.161
 
Source Farmeconomia. Health economics and therapeutic pathways; Vol 10, No 1 (2009); 33-46
2240-256X
1721-6915
 
Language eng
 
Relation https://journals.edizioniseed.it/index.php/FE/article/view/161/154
 
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http://creativecommons.org/licenses/by-nc/4.0