Apresentação realizada em Oslo - Noruega, 2015.

1. BUDGET IMPACT ANALYSIS OF PERTUZUMAB + TRASTUZUMAB FOR METASTATIC BREAST
CANCER IN THE PERSPECTIVE OF BRAZILIAN PUBLIC HEALTH SYSTEM
Luiza Grazziotin¹; Osvaldo Ulises Garay²; Paulo Dornelles Picon¹; Andrés Pichon-Riviere²
1. Federal University of Rio Grande do Sul, Porto Alegre, Brazil; 2. IECS - Institute for Clinical Effectiveness and
Health Policy, Buenos Aires, Argentina.
INTRODUCTION
The novel monoclonal antibody pertuzumab has
demonstrated relevant clinical improvement in HER-2
positive metastatic breast cancer (HER2+ MBC) patients
when added to trastuzumab + docetaxel.[1] Decision-
makers of the Brazilian public health system (SUS) have
not yet decided about their incorporation in the
metastatic setting. Considering the potential costs that
might incur, a budget-impact analysis is remarkably
essential. Therefore, we aim to estimate the economic
impact of incorporating pertuzumab + trastuzumab in
the SUS, as an addition to currently available treatment
options for HER2+ MBC.
CONCLUSION
METHODS
A budget-impact model was designed using Microsoft
Excel and a freely available web software to include
uncertainty in analysis. The target population was
estimated using data from the literature and local
sources (e.g. DATASUS). Direct costs included drugs,
assessments, procedures of oncology reimbursement
packages and adverse reactions. Data were expressed in
U.S. dollars (USD), 2013.
The incorporation of pertuzumab + trastuzumab into the
SUS for the treatment of HER2+ MBC is likely to have a
high impact upon overall health expenditure, since the
net result is a 900% increase of total costs. Therefore, it
is necessary to conduct a cost-effectiveness study in
order to associate costs in line with clinical benefits.
REFERENCES
[1] Swain SM, Kim SB, Cortés J, Ro J, Semiglazov V, Campone M, Ciruelos E, Ferrero JM,
Schneeweiss A, Knott A, Clark E, Ross G, Benyunes MC, Baselga J. Pertuzumab, trastuzumab,
and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA study): overall survival
results from a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Oncology.
2013 May;14(6):461-71.
RESULTS
The target population was estimated in 2.142 patients
(IC 95% 1.722 – 2.562). Current clinical protocol covered
by SUS costs USD 21.097.423 (IC 95% 13.097.748 –
27.172.931). The incremental cost of adding pertuzumab
+ trastuzumab was estimated to be USD 89.571,36 (IC
95% 55.650,36 – 115.410,6) per patient per year. This
would represent an annual budgetary impact of USD
212.959.333 (IC 95% 132.326.470 – 274.382.606)
assuming diffusion rate of 100%. The unitary cost of
trastuzumab and pertuzumab were the most influential
factors in this analysis.
Figure 2. Proportion of factor`s influence over the total budgetary
impact.
Figure 1. Budget impact of trastuzumab + pertuzumab in a 3-years
horizon (diffusion rates: 50%, 75% and 100%).