Budgetary Impact on a U.S. Health Plan Adopting Abiraterone Acetate Plus Prednisone for the Treatment of Patients with Metastatic Castration-Resistant Prostate Cancer

Sorensen, Sonja; Ellis, Lorie; Wu, Ying; Hutchins, Valerie; Linnehan, John E; Senbetta, Mekré

doi:10.18553/jmcp.2013.19.9.799

Cited by 25 publications

(34 citation statements)

References 21 publications

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“…For ten of the models of chronic illness, the clinical data indicated that a decrease in mortality or disease progression rates during the model time horizon would be expected with use of the new drug [47][48][49][50][51][52][53][54][55][56]. Eight of these models used a simple cost-calculator model structure [47][48][49][50][51][52][53][54], and only two used a decision-analytic model structure [55,56].…”

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

“…Eight of these models used a simple cost-calculator model structure [47][48][49][50][51][52][53][54], and only two used a decision-analytic model structure [55,56]. Seven of the eight cost-calculator models were for advanced or metastatic cancers [47-51, 53, 54], and one was for congestive heart failure [52].…”

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

“…Of the eight models that used the static cost-calculator approach, four used a prevalent population with the condition for which the new drug was indicated and assumed no change in population size during the model time horizon [50][51][52][53]. The other four models used an incident population capturing only those newly indicated for treatment with the new drug [47][48][49]54].…”

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

“…Although these studies all focused on chronic conditions, seven of the eight cost-calculator models assumed a time horizon of 1 year [47][48][49][51][52][53][54], either assuming that the mortality rates were sufficiently high that no patients would be alive in subsequent years for those with advanced cancer or that the budget impact would be the same in subsequent periods for those with congestive heart failure. In the other cost-calculator model [50] and the two decision-analytic models [55,56], time horizons varied from 3 to 10 years.…”

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

“…Five of the ten studies compared the current or old treatment mix with a new treatment mix including the new drug [47,50,51,53,54]. In all five of these studies, the drug for which the budget impact was estimated took treatment share from all drugs.…”

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

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A Methodological Review of US Budget-Impact Models for New Drugs

Mauskopf

Earnshaw

2016

PharmacoEconomics

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A budget-impact analysis is required by many jurisdictions when adding a new drug to the formulary. However, previous reviews have indicated that adherence to methodological guidelines is variable. In this methodological review, we assess the extent to which US budgetimpact analyses for new drugs use recommended practices. We describe recommended practice for seven key elements in the design of a budget-impact analysis. Targeted literature searches for US studies reporting estimates of the budget impact of a new drug were performed and we prepared a summary of how each study addressed the seven key elements. The primary finding from this review is that recommended practice is not followed in many budgetimpact analyses. For example, we found that growth in the treated population size and/or changes in disease-related costs expected during the model time horizon for more effective treatments was not included in several analyses for chronic conditions. In addition, all drug-related costs were not captured in the majority of the models. Finally, for most studies, one-way sensitivity and scenario analyses were very limited, and the ranges used in one-way sensitivity analyses were frequently arbitrary percentages rather than being data driven. The conclusions from our review are that changes in population size, disease severity mix, and/or disease-related costs should be properly accounted for to avoid over-or underestimating the budget impact. Since each budget holder might have different perspectives and different values for many of the input parameters, it is also critical for published budget-impact analyses to include extensive sensitivity and scenario analyses based on realistic input values. Key Points for Decision MakersPublished budget-impact analyses do not always estimate changes in the treated population size and related changes in the disease-related costs of drugs for chronic conditions that reduce mortality rates or slow disease progression, which may result in overor underestimates of the budget impact of a new drug.Treatment switching or discontinuation may not be appropriately included in many published budgetimpact analyses.Sensitivity and scenario analyses presented in published budget-impact analyses are typically too limited to allow a budget holder to assess the likely budget impact for their health plan.

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Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

Section: Decreased Mortality or Disease Progression Ratesmentioning

confidence: 99%

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A Methodological Review of US Budget-Impact Models for New Drugs

Mauskopf

Earnshaw

2016

PharmacoEconomics

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Economic Impact of Prostate Cancer Bone Metastases

Restelli

Dellavedova

Croce

et al. 2016

Bone Metastases From Prostate Cancer

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Does Biosimilar Bevacizumab Offer Affordable Treatment Options for Cancer Patients in the USA? A Budget Impact Analysis from US Commercial and Medicare Payer Perspectives

Yang

Liu

Ektare

et al. 2021

Appl Health Econ Health Policy

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Background Bevacizumab remains the most widely used and most thoroughly characterized angiogenesis inhibitor for a range of advanced cancers. Bevacizumab-bvzr (Zirabev ® ), a biosimilar of bevacizumab, was recently approved by the US Food and Drug Administration (FDA), which provides a less costly option. This study aimed to evaluate the financial impact of introducing bevacizumab-bvzr from US commercial and Medicare payer perspectives. Methods A Microsoft Excel-based budget impact model was developed over a 5-year time horizon. Target population was patients to be treated with bevacizumab for FDA-approved indications. Drug costs (2020 US$) were based on average sales price and wholesale acquisition cost, accounting for payer-specific reimbursement models and provider settings. Drug dosing and duration were based on prescribing information and pivotal trial publications. Results In a hypothetical 10-million-member health plan, 503 and 723 patients were estimated to be treated with bevacizumab in year 1 and year 5, respectively. Assuming an annual market shift of 1.7%,

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Budgetary Impact on a U.S. Health Plan Adopting Abiraterone Acetate Plus Prednisone for the Treatment of Patients with Metastatic Castration-Resistant Prostate Cancer

Abstract: BACKGROUND: Abiraterone acetate, an androgen biosynthesis inhibitor, received FDA approval in 2011 for metastatic castration-resistant prostate cancer (mCRPC) patients who have received prior chemotherapy containing docetaxel.

Cited by 25 publications

References 21 publications

A Methodological Review of US Budget-Impact Models for New Drugs

A Methodological Review of US Budget-Impact Models for New Drugs

Economic Impact of Prostate Cancer Bone Metastases

Does Biosimilar Bevacizumab Offer Affordable Treatment Options for Cancer Patients in the USA? A Budget Impact Analysis from US Commercial and Medicare Payer Perspectives

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