Cost of First-Line Treatment of Hepatocellular Carcinoma With the Immune Checkpoint Inhibitor-Based Regimens STRIDE and Atezolizumab Plus Bevacizumab in Brazil
Author(s)
Barry Rodgers-Gray, BSc, MSc, PhD1, Marília Hernani, MSc2, Carolina Meyn Teixeira, Specialized postgraduate degree2, Ricardo Paranhos Moreira, Sr., MD3, Ian Keary, PhD4, John Fullarton, PhD4, MELDA DINC, MSc5, Li Sun, PhD6, Kate Keeping, BSc6, Doreen Tay, MSc7.
1Dr, Violicom Medical Limited, EASTLEIGH, United Kingdom, 2AstraZeneca, São Paulo, Brazil, 3AstraZeneca, SÃO PAULO, Brazil, 4Violicom Medical Limited, Aldermaston, United Kingdom, 5AstraZeneca, ISTANBUL, Turkey, 6AstraZeneca, Cambridge, United Kingdom, 7AstraZeneca, Singapore, Singapore.
1Dr, Violicom Medical Limited, EASTLEIGH, United Kingdom, 2AstraZeneca, São Paulo, Brazil, 3AstraZeneca, SÃO PAULO, Brazil, 4Violicom Medical Limited, Aldermaston, United Kingdom, 5AstraZeneca, ISTANBUL, Turkey, 6AstraZeneca, Cambridge, United Kingdom, 7AstraZeneca, Singapore, Singapore.
OBJECTIVES: The efficacy of STRIDE (Single Tremelimumab Regular Interval Durvalumab) for the first-line treatment of hepatocellular carcinoma was established in the HIMALAYA trial. Atezolizumab plus bevacizumab (A+B) is another immune checkpoint inhibitor-based regimen available in Brazil. This analysis considers the total cost of care associated with STRIDE versus A+B in the Brazilian private healthcare context (payer perspective).
METHODS: A model considering the costs of associated work-up prior to treatment, treatment acquisition and administration, and the management of subsequent grade ≥3 adverse events (AEs) associated with each regimen was developed. Healthcare costs were calculated using a micro-costing approach based on available Brazilian sources (updated to 2024 values). Drug costs were based on current list prices of the originator products. Treatment duration (5.5 months for STRIDE and 7.4 months for A plus 6.9 months for B) and AE rates were taken from the respective trials. The incident population was calculated based on available epidemiological data and Brazilian population statistics.
RESULTS: Based on an incident population of 945, the cost of care for STRIDE was R$388,277,623 (€62,124,420) versus R$498,183,754 (€79,709,401) for A+B. This corresponded to a saving with STRIDE of R$109,906,131 (€17,584,981, 22.1%) versus A+B. On a per patient basis, the saving with STRIDE was R$116,321 (€18,611). Absolute cost savings were driven primarily by treatment acquisition costs (incident population: R$103,434,429 [€16,549,509], 21.7%). However, this advantage was further extended by savings in all other domains considered: work-up (R$4,551,408 [€728,255], 25.3%), treatment administration (R$863,128 [€138,100], 66.7%), and AE management (R$916,943 [€146,711], 80.1%). When bevacizumab price was adjusted according to market share (April 2025) including biosimilar products acquisition cost, savings with STRIDE versus A+B were R$12,168,014 (€1,946,882, 3.1%) and total savings were R$18,639,716 (€2,982,355, 4.6%).
CONCLUSIONS: Taking a total cost of care approach, STRIDE was associated with cost savings compared with A+B from a Brazilian private healthcare perspective.
METHODS: A model considering the costs of associated work-up prior to treatment, treatment acquisition and administration, and the management of subsequent grade ≥3 adverse events (AEs) associated with each regimen was developed. Healthcare costs were calculated using a micro-costing approach based on available Brazilian sources (updated to 2024 values). Drug costs were based on current list prices of the originator products. Treatment duration (5.5 months for STRIDE and 7.4 months for A plus 6.9 months for B) and AE rates were taken from the respective trials. The incident population was calculated based on available epidemiological data and Brazilian population statistics.
RESULTS: Based on an incident population of 945, the cost of care for STRIDE was R$388,277,623 (€62,124,420) versus R$498,183,754 (€79,709,401) for A+B. This corresponded to a saving with STRIDE of R$109,906,131 (€17,584,981, 22.1%) versus A+B. On a per patient basis, the saving with STRIDE was R$116,321 (€18,611). Absolute cost savings were driven primarily by treatment acquisition costs (incident population: R$103,434,429 [€16,549,509], 21.7%). However, this advantage was further extended by savings in all other domains considered: work-up (R$4,551,408 [€728,255], 25.3%), treatment administration (R$863,128 [€138,100], 66.7%), and AE management (R$916,943 [€146,711], 80.1%). When bevacizumab price was adjusted according to market share (April 2025) including biosimilar products acquisition cost, savings with STRIDE versus A+B were R$12,168,014 (€1,946,882, 3.1%) and total savings were R$18,639,716 (€2,982,355, 4.6%).
CONCLUSIONS: Taking a total cost of care approach, STRIDE was associated with cost savings compared with A+B from a Brazilian private healthcare perspective.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE180
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies, Trial-Based Economic Evaluation
Disease
Oncology