Integrated budget impact model to estimate the impact of introducing selpercatinib as a tumor-agnostic treatment option for patients with RET-altered solid tumors in the US.

IF 2.9 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of Medical Economics Pub Date : 2024-01-01 Epub Date: 2024-03-06 DOI:10.1080/13696998.2024.2317120
Naleen Raj Bhandari, Adrienne M Gilligan, Julie Myers, Amine Ale-Ali, Lee Smolen
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Abstract

Objective: To estimate the potential budget impact on US third party payers (commercial or Medicare) associated with addition of selpercatinib as a tumor-agnostic treatment for patients with Rearranged during Transfection (RET)-altered solid tumors.

Methods: An integrated budget impact model (iBIM) with 3-year (Y) time horizon was developed for 19 RET-altered tumors. It is referred to as an integrated model because it is a single model that integrated results across multiple tumor types (as opposed to tumor-specific models developed traditionally). The model estimated eligible patient populations and included tumor-specific comparator treatments for each tumor type. Estimated annual total costs (2022USD, $) included costs of drug, administration, supportive care, and toxicity. For a one-million-member plan, the number of patients with RET-altered tumors eligible for treatment, incremental total costs, and incremental per-member per-month (PMPM) costs associated with introduction of selpercatinib treatment were estimated. Uncertainty associated with model parameters was assessed using various sensitivity analyses.

Results: Commercial perspective estimated 11.68 patients/million with RET-altered tumors as treatment-eligible annually, of which 7.59 (Y1), 8.17 (Y2), and 8.76 (Y3) patients would be selpercatinib-treated (based on forecasted market share). The associated incremental total and PMPM costs (commercial) were estimated to be: $873,099 and $0.073 (Y1), $2,160,525 and $0.180 (Y2), and $2,561,281 and $0.213 (Y3), respectively. The Medicare perspective estimated 55.82 patients/million with RET-altered tumors as treatment-eligible annually, of which 36.29 (Y1), 39.08 (Y2), and 41.87 (Y3) patients would be selpercatinib-treated. The associated incremental total and PMPM costs (Medicare) were estimated to be: $4,447,832 and $0.371 (Y1), $11,076,422 and $0.923 (Y2), and $12,637,458 and $1.053 (Y3), respectively. One-way sensitivity analyses across both perspectives identified drug costs, selpercatinib market share, incidence of RET, and treatment duration as significant drivers of incremental costs.

Conclusions: Three-year incremental PMPM cost estimates suggest a modest impact on payer-budgets associated with introduction of tumor-agnostic selpercatinib treatment.

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综合预算影响模型,估算在美国引入赛帕替尼作为RET改变的实体瘤患者的肿瘤诊断治疗方案的影响。
目的估算将色瑞帕替尼作为一种肿瘤诊断性治疗方法用于转染重组(RET)改变的实体瘤患者时,对美国第三方支付机构(商业或医疗保险)的潜在预算影响:方法:针对19种RET改变的肿瘤,开发了一个三年(Y)时间跨度的综合预算影响模型(iBIM)。之所以称其为综合模型,是因为它是一个整合了多种肿瘤类型结果的单一模型(与传统开发的特定肿瘤模型不同)。该模型估算了符合条件的患者人群,并为每种肿瘤类型纳入了肿瘤特异性比较治疗方法。估算的年度总成本(2022 年美元)包括药物成本、管理成本、支持性护理成本和毒性成本。在百万成员计划中,估算了符合治疗条件的 RET 改变肿瘤患者人数、增量总成本以及与引入赛帕替尼治疗相关的增量每人每月 (PMPM) 成本。利用各种敏感性分析评估了与模型参数相关的不确定性:从商业角度估计,每年有 11.68 名/百万名 RET 改变肿瘤患者符合治疗条件,其中 7.59 名(Y1)、8.17 名(Y2)和 8.76 名(Y3)患者将接受舍帕替尼治疗(基于预测的市场份额)。相关增量总成本和 PMPM 成本(商业)估计分别为:873,099 美元和 0.073 美元(Y1)、2,160,525 美元和 0.180 美元(Y2)以及 2,561,281 美元和 0.213 美元(Y3)。从医疗保险的角度估计,每年有 55.82 名/百万名 RET 改变肿瘤患者符合治疗条件,其中 36.29 名(Y1)、39.08 名(Y2)和 41.87 名(Y3)患者将接受赛帕替尼治疗。据估计,相关的增量总成本和 PMPM 成本(医疗保险)分别为:4,447,832 美元和 0.371 美元(Y1)、11,076,422 美元和 0.923 美元(Y2)以及 12,637,458 美元和 1.053 美元(Y3)。对两种观点进行的单向敏感性分析表明,药物成本、赛哌卡替尼市场份额、RET发病率和治疗持续时间是增量成本的重要驱动因素:结论:三年的增量 PMPM 成本估算表明,引入肿瘤诊断性色瑞帕替尼治疗对支付方预算的影响不大。
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来源期刊
Journal of Medical Economics
Journal of Medical Economics HEALTH CARE SCIENCES & SERVICES-MEDICINE, GENERAL & INTERNAL
CiteScore
4.50
自引率
4.20%
发文量
122
期刊介绍: Journal of Medical Economics'' mission is to provide ethical, unbiased and rapid publication of quality content that is validated by rigorous peer review. The aim of Journal of Medical Economics is to serve the information needs of the pharmacoeconomics and healthcare research community, to help translate research advances into patient care and be a leader in transparency/disclosure by facilitating a collaborative and honest approach to publication. Journal of Medical Economics publishes high-quality economic assessments of novel therapeutic and device interventions for an international audience
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