OBJECTIVES

: To determine the clinical and economic benefits that the inclusion of Pertuzumab as a neoadjuvant treatment in HER2 + breast cancer would mean through an innovative payment method selected in the public sector in Ecuador.

METHODS

: We performed the scientific literature analysis of pivotal clinical studies to identify the main efficacy results among the therapeutic alternatives for the indicated indication. For local economic analyzes they were consulted major public repositories drug prices, and the statistical service of the hospitals included in the study. The perspective of the analysis was that of the payer, only the costs related to the pharmacological treatment that includes the inclusion of Pertuzumab in the national coverage plan were included, the rest of the medication is reimbursed at the public level.

RESULTS

: In the NEOSPHERE clinical trial was identified that the combination of pertuzumab + trastuzumab + docetaxel achieved a significant increase in the complete pathological response rate (CPR) (49 of 107 patients; 45.8% [95% CI 36.1–55.7]) compared to different control arms of the study. For the economic analysis, the time horizon was 3 years, and 20 new patients were included each year who would receive coverage with the requested medication and where compliance with the complete pathological response after the surgery performed would be determined. In our simulation, the implementation of a differential payment model would begin for those patients who did not present the CPR after Neoadjuvant treatment, would obtain a benefit in the following adjuvant therapy that corresponds to the patient, thus increasing the possibilities of clinical improvement without substantially affecting in the financial aspect.

CONCLUSIONS

: The implementation of a new payment model for the inclusion of Pertuzumab in the national formulary list for neoadjuvant cancer patients could expand the portfolio of drugs in specialty hospitals and protect the financial sustainability of the health system.