PCN123 EVALUATION OF DRUG THERAPY COSTS FOR PATIENTS WITH BREAST CANCER, MELANOMA AND RENAL CELL CARCINOMA IN MOSCOW IN 2016-2017
V. Krysanova, K. Poliakova, T. Ermolaeva, M. Davydovskaya, K. Kokushkin
State Budgetary Institution of Moscow City “Clinical Trials and Healthcare Technology Assessment Scientific-Research Centre of Moscow Department of Healthcare”, Moscow, Russian Federation
OBJECTIVES: To assess the preferential drug coverage for cancer’s patients in Moscow in 2016-2017 for the most costly oncological diseases – breast cancer (BC), melanoma (MEL), renal cell carcinoma (RCC). METHODS : To conduct retrospective analysis of drugs utilization and cost in Moscow in 2016-2017 for patients with BC, MEL, RCC analytical model, relying on depersonalized data from regular database of reimbursed drug prescription of the Moscow City Health Department, has been developed. To evaluate the costs of drug therapy differentiation was conducted – chemotherapy (CT), immunotherapy (IT), targeted therapy (TT), endocrine therapy (ET) and concomitant therapy (CcT) (Fig.2). The 10 most high-cost medications in 2016-2017 for each diseases were analyzed (Tab. 1).
Table 1. The most high-cost drugs for cancer patients in Moscow in 2016-2017
2016 2017
Trastuzumab Trastuzumab Fulvestrant Fulvestrant Eribuline Eribuline Docetaxel Pertuzumab+Trastuzumab Pertuzumab+Trastuzumab Docetaxel BC Lapatinib Trastuzumab emtansine Zoledronic Acid Goserelin Paclitaxel Everolimus Trastuzumab emtansine Paclitaxel Goserelin Lapatinib Vemurafenib Ipilimumab Dabrafenib Vemurafenib Trametinib Dabrafenib Temozolomide Nivolumab Figure 1. General characteristic of the analysis Interferon α-2b Trametinib MEL Tumor necrosis factor α-1 Pembrolizumab Pazopanib Cobimetinib RESULTS: For BC in 2017 the main share of costs was to CT (55%), 2nd place – ET (19%), 3rd place – IT (4%) Paclitaxel Temozolomide (Fig.2). Compared to 2016, the costs of CT decreased and of ET increased, new type of therapy – IT – appeared. The Vandetanib Interferon α-2b most high-cost drug was trastuzumab in 2016-2017. For MEL in 2017 the main share of costs was to TT (96%), 2nd Fotemustin Fotemustin place – CT (1.5%), 3rd place – IT (1%) (Fig.3). Compared with 2016, the costs of CT significantly decreased and of Sorafenib Sunitinib TT increased. The structure of costs of drugs prescription has changed, because clinical practice has included new TT Sunitinib Pazopanib and IT drugs (ipilimumab, nivolumab, pembrolizumab, cobimetinib). The most high-cost drug was vemurafenib in Pazopanib Sorafenib 2016, ipilimumab in 2017. For RCC in 2017 the main share of costs was to TT (86%), 2nd place – IT (12%), 3rd Everolimus Everolimus place - CcT (0.3%) (Fig.4). Compared to 2016, the distribution of costs remained at the same level, a new drug Axitinib Axitinib RCC nivolumab appeared. The most high-cost drug was sorafenib in 2016, sunitinib in 2017. Temsirolimus Temsirolimus Bevacizumab Lenvatinib Zoledronic Acid Nivolumab Disclosure: Study was conducted without any support. Denosumab Bavacizumab Fentanyl Denosumab Figure 2. Breast cancer Figure 3. Melanoma Figure 4. Renal Cell Carcinoma
CONCLUSIONS: There is a general tendency to reduce the costs for chemotherapy, in connection with the emergence and introduction into clinical practice of new targeted and immune drugs that have higher efficacy and cost. Contacts: 12-2, Minskaya st., Moscow, Russia, 121096. Tel. +7(499)144-00-30, e-mail: [email protected]