Pembrolizumab as second-line therapy in non-small cell lung cancer in northern Norway: budget impact and expected gain—a model-based analysis
AuthorNorum, Jan; Antonsen, Margaret Aarag; Tollåli, Geir; Al-Shibli, Khalid; Andersen, Gry; Svanqvist, Kristin-Helene; Helbekkmo, Nina
1 Norum J, et al . ESMO Open 2017; 2 :e000222. doi:10.1136/esmoopen-2017-000222 Open Access Abstr A ct Background P embrolizumab is a new drug approved in several countries for second-line therapy in non-small cell lung cancer (NSCLC) being programmed cell death ligand (PD-L1) positive. This drug has a high cost, and the cost- effectiveness ratio has been debated. Patients and methods The budget impact to the Northern Norwegian Regional Health Authority trust of implementing pembrolizumab in second-line therapy in patients with PD-L1-positive NSCLC was calculated. A model was developed employing data from the Cancer Registry of Norway, the KEYNOTE-010 study, the price list from The Hospital Pharmacy of North Norway, the cost of analysing PD-L1 expression and the cost of travelling. Today’s cost of second-line therapy was compared with the new standard employing pembrolizumab. The sale price of pembrolizumab in Norway was not published due to price confidentiality. Norwegian krone (NKr) was converted into Euros ( € ) at a rate of 1 € =Nkr 8.8138. (Bank of Norway, 21 February 2017). Results 105 new pa tients were identified available for pembrolizumab per year. The annual cost of pembrolizumab was € 5.2 million, hospital pharmacy administration costs € 0.1 million, PD-L1 testing € 0.3 million, oncologist/pulmonologist/nurses € 0.2 million, radiology € 0.06 million and transporta tion € 0.4 million. Savings due to avoided present second-line therapy was calculated € 0.4 million. Consequently, the cost of implementing pembrolizumab was € 5.5 million and the annual budget impact was € 5.0 million. A mean gain of at least 9 months per patient treated was necessary to make pembrolizumab cost-effective. Conclusions The net budget impact of pembrolizumab was € 5.0 million. The expenditure could not be indicated cost-effective. Price confidentiality is a growing problem in health economics and it has become a ‘menu without prices’ setting.
CitationNorum J et al. Pembrolizumab as second-line therapy in non-small cell lung cancer in northern Norway: budget impact and expected gain—a model-based analysis. ESMO Open Cancer Horizons. 2017;2
Showing items related by title, author, creator and subject.
The Use of eHealth and Provider-Based Health Services by Patients with Diabetes Mellitus: Protocol for a Cross-Sectional Study Hansen, Anne Helen; Bradway, Meghan; Brož, Jan; Claudi, Tor; Henriksen, Øystein; Wangberg, Silje C; Årsand, Eirik (Journal article; Tidsskriftartikkel; Peer reviewed, 2016-10-31)<b>Background:</b> The prevalence of diabetes and the use of electronic health (eHealth) resources are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great significance in this regard. However, little is known about the extent to which different kinds of eHealth tools are used, and how the use of eHealth is associated ...
Cochrane Collaboration Systematic Reviews may be based on trials not approved by a research ethics committee Jokstad, Asbjørn (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-10-27)Systematic reviews (SR) may potentially contain reports of primary trials with ethical problems. The Cochrane Collaboration SRs are considered as the highest standard in evidence-based health care resources. All SRs completed during the last 5 years (2013–2017) under the management of the Oral Health Group of the Cochrane Collaboration were identified. All primary trials included in the Oral Health ...
Mortality reduction in poor countries: exploring the association with health system resources and economic growth Amundrød, Eli Wik (Master thesis; Mastergradsoppgave, 2012-05-01)Population health (measured in terms of life expectancy and under-five mor-tality rate) has improved under the era of the Millennium Development Goals. The aim of the thesis was to examine the association between population health and health care resources in poor countries, to better understand the situation and how to improve it. I have done an ecological analysis of aggregate data. The sample ...