1037PD - Drug cost per gained month in overall survival (OS) and progression-free survival (PFS) of selected solid tumour therapies in Nordic countries

Date 27 September 2014
Event ESMO 2014
Session Challenges in cancer screening and care: dealing with the issues of access and cost of therapy
Topics Bioethics, Legal, and Economic Issues
Presenter Pia Osterlund
Citation Annals of Oncology (2014) 25 (suppl_4): iv357-iv360. 10.1093/annonc/mdu341
Authors P.J. Osterlund1, P. Pfeiffer2, R. Smaaland3, F. Rodrigues4, G. Furneri5
  • 1Medical Oncology, Helsinki University Central Hospital Oncology, 00029 - Helsinki/FI
  • 2Oncology, Odense University Hospital, DK-5000 Odense C - Odense/DK
  • 3Hematology And Oncology, Stavanger University Hospital, Stavanger/NO
  • 4Market Access, Celgene AB, Kista/SE
  • 5Market Access, EBMA Consulting, 20077 - Melegnano/IT

 

Abstract

Aim

Regional and hospital payers increasingly require analyses assessing the cost-benefit profile of new drugs. This analysis evaluates the cost profile in Nordic countries of nano albumin-bound paclitaxel (nab-paclitaxel [nab-P]) in pancreatic cancer vs other drugs per gained month in OS and PFS in high-unmet need solid tumour indications.

Methods

Trial data on solid tumour therapies (comparator, treatment duration, PFS, OS) was retrieved from the European Medicine Agency (EMA) website. Total drug costs were calculated from ex-manufacturer prices without local discounts, using minimization of wastage and costs, and multiplying each drug cost by its maximum number of cycles or until disease progression, according to posology indications. Costs per month of OS and PFS achieved (dividing total drug costs by OS and PFS months, respectively) were evaluated for a selection of drugs: (1) trials for first-line metastatic cancer or noncurable treatment intention patients; (2) approved by EMA after 2000; (3) indicated in high-unmet need tumours (defined as OS for trial comparator ≤ 12 mo).

Results

Results for the OS analysis are shown on the table:

In all countries, a good correlation between costs per OS month and relative benefit vs trial comparator was observed. Similar correlation was found for the PFS analysis.

Conclusions

The most recently approved drug, nab-P in pancreatic cancer, showed a similar cost per OS or PFS month ratio compared with other drugs for high-unmet need solid tumours.

Drug Indication (year of EMA approval) Relative OS Gain vs Trial Comparator Total Drug Cost per OS Month (€)
Norway Denmark Finland Sweden
nab-P Pancreas (2014) 27% 1407 1697 2003 2280
Pemetrexed Mesothelioma (2004) 30% 1875 1886 1991 2064
Bevacizumab Lung (2007) 19% 1810 1531 1620 1722
Cetuximab Head and neck (2004) 36% 3036 2865 2828 2972
Trastuzumab Stomach (2009) 24% 1743 1008 1786 1945
Erlotinib Pancreas (2006) 7% 1119 870 1209 950
Tegafur/gimeracil/ oteracil (Teysuno S-1) Stomach (2011) 9% 264 236 185 249
Temsirolimus Kidney (2007) 49% 1736 1315 1411 1539
Vemurafenib Melanoma (2012) 40% 5864 4700 4814 4,919
Ipilimumab Melanoma (2011) 67% 8741 6725 6964 7248

Disclosure

P. Österlund: No financial disclosures, panelist on the Metastatic pancreatic cancer webcast for Celgene in April 2014; P. Pfeiffer: No financial disclosures, chairman on the Metastatic pancreatic cancer webcast for Celgene in April 2014; R. Smaaland: Rune Smaaland has no financial disclosures. He has been in the scientific panel on the Metastatic pancreatic cancer webcast for Celgene in April 2014; F. Rodrigues: Employment or leadership position and stock ownership, Celgene; G. Furneri: No financial disclosures, panelist on the Metastatic pancreatic cancer webcast for Celgene in April 2014; Consulting fees from Celgene.