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B. Gutierres
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P1.11 - Patient Advocacy (ID 697)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Patient Advocacy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.11-001 - Economic Impact of Immune Checkpoint Inhibitor Therapy in Brazil and Strategies to Improve Access (ID 7516)
09:30 - 09:30 | Author(s): B. Gutierres
- Abstract
Background:
Immunotherapy was elected by ASCO as the most important advance in Oncology in the last 2 consecutive years. Harnessing the immune system to fight cancer cells has already changed clinical practice. Nevertheless, the cost of immune checkpoint inhibitors is a limitation to their incorporation in several countries, including Brazil. The objective of this study was to estimate the economic impact of immunotherapy and make suggestions in order to improve access for patients who benefit the most from treatment.
Method:
We assessed Brazilian cancer epidemiology data and the international literature to estimate the number of eligible patients each year. The authors estimated the economic impact according to the local medication acquisition costs converted to US dollars. The median duration of the treatment was based upon the randomized clinical trials.
Result:
We assessed 3 different agents (and one combo) for 4 indications in the treatment of lung cancer. The results are summarized in the table below.Drug NSCLC 1L NSCLC 2L TOTAL Number of Eligible Patients (% of all cancer patients) Increase in Cancer Drug Total Expenditure Cost in the Public Health System Additional Cost Per Citizen LYG Cost per LYG Nivo NA 173.0 mi All Comers 173.0 mi -10%: 154.1 -20%: 135.1 4,733 (1.0) +21.6% +19.3% +16.9% $0.90 $0.77 $0.68 0.57 $99,467 Pembro 354.0 mi PD-L1>50% (monoTx) 898.5 mi PD-L1<50% (+chemo) 100.0 mi PD-L1>1% 1,352 mi -10%: 1,211 -20%: 1,070 16,362 (3.5) +169% +151% +134% $6.76 $6.06 $5.35 Mono 0.73 +chemo 0.55 2L 0.69 $156,164 $200,684 $49,007 Atezo NA 255.6 mi All Comers 255.6 mi -10%: 228.4 -20%: 201.2 4,733 (1.0) +32.0% +28.6% +25.2% $1.28 $1.14 $1.01 0.74 $103,095
Conclusion:
The current cost of immune checkpoint inhibitors is prohibitive in the public health system in Brazil. While the country’s GDP per capita is 78% lower than that of the US, immune checkpoint inhibitors have similar prices in both. Biomarker selection, posology and lower cost drugs help decrease the total economic impact of therapy. Price discrimination and volume discounts would help improve access. Further studies and discussion with all stakeholders is needed to identify patients who would benefit the most and to implement strategies to increase access to these potentially life-saving therapies.
