Pharmacoeconomic analysis of pembrolizumab in combination with chemotherapy as the first line of advances non-squamous nonsmall cell lung cancer treatment
- Authors: Zyryanov S.K1, Frolov M.Y.2,3, Zhuravleva M.V4, Rogov V.A2, Sakaeva D.D.5,6
-
Affiliations:
- Peoples' Friendship University of Russia
- Volgograd State Medical University
- Association of Clinical Pharmacologists
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
- Republican Clinical Oncological Dispensary
- Bashkir State Medical University
- Issue: No 12 (2018)
- Pages: 105-114
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/295854
- DOI: https://doi.org/10.18565/pharmateca.2018.12.105-114
- ID: 295854
Cite item
Open Access
Access granted
Abstract
Background. Lung cancer is the most common cause of death among oncology diseases in the Russian Federation and represents a serious social and economic problem. Until recently, for patients without activated mutations, standard chemotherapy (CT) was the only treatment option. The PD-1 receptor inhibitor pembrolizumab is the first drug that, in combination with HT, has shown efficacy in patients with advanced non-squamous NSCLC in the first line of therapy. Objective: to evaluate the cost-effectiveness of using pembrolizumab in combination with CT in the first line of conventional non-squamous NSCLC therapy in frame of Russian public health care system. Methods. The use of pembrolizumab in combination with platinum-based chemotherapy and pemetrexed was compared with platinum-based chemotherapy and pemetrexed therapy in the first line of common non-squamous NSCLC. The Markov model was developed to estimate the number of life years saved and direct medical costs for compared treatment regimens, based on data from the KEYNOTE-189 clinical study. Additionally, «cost/effectiveness» and «cost/utility» analyzes were performed. Results. 5-year general direct costs per patient on pembrolizumab with CT (7,06 million rubs.) is higher than the cost on CT (4,35 million rubs.). The «cost/effectiveness» ratio for a life year for therapy with pembrolizumab with CT is 2,67 million rubs., and 2,72 million rubs. for СТ. The «cost/utility» ratio for quality adjusted life year for pembrolizumab therapy with CTis 3,65 million rubs, and 3,96 million rubs. for CT. Conclusion. The use of pembrolizumab in combination with CT is economically feasible in the first line of therapy of common non-squamous NSCLC in the healthcare conditions of the Russian Federation.
Full Text
About the authors
S. K Zyryanov
Peoples' Friendship University of Russia
M. Yu Frolov
Volgograd State Medical University; Association of Clinical Pharmacologists
M. V Zhuravleva
I.M. Sechenov First Moscow State Medical University (Sechenov University)
V. A Rogov
Volgograd State Medical University
Dina D. Sakaeva
Republican Clinical Oncological Dispensary; Bashkir State Medical University
Email: d_sakaeva@mail.ru
MD, Deputy Chief Physician for Chemotherapy
References
- Ferlay J., Soerjomataram I., Dikshit R., et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer. 2015;136(5):359-86.
- Jemal A., Siegel R., Xu J., Ward E. Cancer statistics, 2010. CA Cancer J. Clin. 2010;60(5):277-300.
- De la Cruz C.S., Tanoue L.T., Matthay R.A. Lung cancer: epidemiology, etiology, and prevention. Clin. Chest Med. 2011;32 (4):605-44.
- Каприн А.Д., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2016 г. (заболеваемость и смертность). М., 2018.
- Каприн А.Д., Старинский В.В., Петрова Г.В. Состояние онкологической помощи населению России в 2017 г М., 2018. [Kaprin A.D., Starinskiy V.V., Petrova G.V The state of cancer care for the population of Russia in 2017. Мoscow, 2018. (In Russ.)].
- Siegel R.L., Miller K.D., Jemal A. Cancer Statistics, CA CANCER J CLIN. 2016;66:7-30.
- Arnold M., Pandeya N., Byrnes G., et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet. Oncol. 2015;16(1):36-46.
- Ramalingam S., Belani C. Systemic chemotherapy for advanced non-small cell lung cancer: Recent advances and future directions. Oncologist: 2008;13:5-13.
- Musina N., Nikitina A., Soshnikov S., et al. Indirect costs and burden of lung of lung cancer in terms of disability adjusted life years during 2015 in Russia. ISPOR 22nd Ann. Int. Meet. Poster Present. PCN84.
- Gerasimova K.V., Soshnikov S., Musina N., et al. Direct non-medical cost of patients with trachea, bronchus and lung cancer in Russia. ISPOR 22nd Ann. Int. Meet. Poster Present. PCN82.
- Ernani V., Ganti A.K. Immunotherapy in treatment naïve advanced non-small cell lung cancer. J. Thorac. Dis. 2018;10 (Suppl. 3):412-21.
- Bylicki O., Paleiron N., Rousseau-Bussac G., Chouaï'd C. New PDL1 inhibitors for non-small cell lung cancer: focus on pembrolizumab. Onco Targets Ther. 2018;11:4051-64.
- Инструкция по применению лекарственного препарата для медицинского применения Китруда. Регистрационный номер: ЛП-0039 72. URL: https://grls.rosminzdrav.ru/Grls_View_ v2.aspx?routingGuid=4a3c420c-d5a1-42a5-8a8d-6f146ae0a71e&t=.
- Gandhi L., Rodrfguez-Abreu D., Gadgeel S., et al. Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer. 2018;378(22):2078-92.
- NCCN Clinical Practice Guidlinesin oncology, NonSmall Cell Lung Cancer Version 5.2018 - June 27.2018 (MS 44).
- Отраслевой стандарт «Клинико-экономические исследования. Общие положения» Приказ Минздрава РФ от 27.05.2002 №163 вместе с ост 91500.14.0001-2002.
- Методические рекомендации по проведению сравнительной клинико-экономической оценки лекарственного препарата. Утверждены приказом ФГБУ ЦЭККМП Минздрава России от 23 декабря 2016г. № 145-од. URL: http://rosmedex. ru/ocenka-texnologij-zdravooxraneniya/ metodicheskie-rekomendacii/.
- Постановление Правительства РФ от 08.12.2017 № 1492 «О Программе государственных гарантий бесплатного оказания гражданам медицинской помощи на 2018 г и на плановый период 2019 и 2020 гг».
- Государственный реестр предельных отпускных цен. Дата обращения: 15.08.2018. URL: http://grls.rosminzdrav.ru/pricelims.aspx.
- Инструкция по группировке случаев, в т.ч. правила учета дополнительных классификационных критериев, и подходам к оплате медицинской помощи в амбулаторных условиях по подушевому нормативу финансирования (письмо ФОМС от 25.01.2018 г. № 938/26-2/и). URL: http://www.ffoms.ru/documents/the-orders-oms/.
- Клинические рекомендации. Рак легкого. МКБ 10: C34. Ассоциация онкологов России. 2018. URL: http://oncology-association.ru/ files/clinical-guidelines_adults%C2%A0-%20 projects2018/rak_legkogo_pr2018.pdf
- Практические рекомендации по лекарственному лечению больных немелкоклеточным раком легкого. Версия 2017. RUSSCO. URL: https://rosoncoweb.ru/standarts/RUSSCO/201 7/ recoms2017_01.pdf.
- Clinical Trial Protocol for: A Randomized, Double-Blind, Phase III Study of Platinum+Pemetrexed Chemotherapy with or without Pembrolizumab (MK-3475) in First Line Metastatic Non-squamous Non-small Cell Lung Cancer Subjects (KEYNOTE-189). EudraCT NUMBER: 2015003694-15.
- Garassino M.C., Rodriguez-Abreu D., Gadgeel S.M., et al. Health-related quality of life (HRQoL) in the KEYNOTE-189 study of pembrolizumab (pembro) or placebo (pbo)+pemetrexed (pem)+platinum (plt) for metastatic NSCLC. J. Clin. Oncol. 2018;36:9021-9021. Doi: 10.1200/ JCO.2018.36.15_suppl.9021.
- Borghaei H. et al. Updated results from KEYNOTE-021 cohort G: A randomized, phase 2 study of pemetrexed and carboplatin (PC) with or without pembrolizumab (pembro) as first-line therapy for advanced nonsquamous NSCLC. Ann Oncol. 2017;28(Issue suppl_5). https://doi. org/10.1093/annonc/mdx440.052.
Supplementary files
