OBJECTIVES: Inotuzumab ozogamicin (IO) is a new drug for acute lymphocytic leukemia (ALL), planned to be registered in Russia soon. The aim of the study was to assess the pharmacoeconomic prospects for the use of IO in patients with refractory or relapsed forms of B-cell ALL, from the public health system perspective and within the framework of drug provision restrictive lists.

METHODS: Modeling Scenario 1 addressed pharmacoeconomic study of IO versus blinatumomab effects. Cost minimization analysis (CMA) and budget impact analysis (BIA) were used. CMA was chosen due to the lack of statistically significant differences in efficacy and safety between the selected strategies. Scenario 2 performed the calculation and comparison of incremental ratios and cost-effectiveness analysis for the use of IO and blinatumomab in comparison with high-dose chemotherapy (HDC).

RESULTS: Results demonstrate the high cost of relapsed and refractory ALL treatment with innovative technologies and HDC, the effectiveness of which is significantly inferior to IO and blinatumomab. The blinatumomab pharmacotherapy is 1.7 times more expensive than IO. The indicator of cost minimization per patient for therapy with IO compared to blinatumomab with a modeling horizon of 18 months amounted to € 69,499, which indicates a 38.4% reduction in direct costs. To assess the feasibility of cost-effectiveness, incremental indicators were calculated. ICER for IO with respect to the use of standard HDC was 77.2% lower than for blinatumomab, which indicates a greater cost-effectiveness for the IO treatment. When increasing the use of IO in the treatment of the target population up to 50%, the costs were reduced by 13.6%, with a total resource-saving effect of up to € 5,469,120.

CONCLUSIONS: Compared with blinatumomab, the use of IO in case of relapsed or refractory ALL is economically viable in the context of CMA and a preferred medical technology from the BIA perspective.