OBJECTIVES

To estimate treatment costs of novel therapies blinatumomab and inotuzumab ozogamicin in the treatment of adult patients with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL) from the Brazilian private healthcare perspective.

METHODS

Treatment costs associated with blinatumomab, a bispecific T-cell engager (BiTE®) antibody construct, and inotuzumab ozogamicin, a CD22 monoclonal antibody were compared. For each therapy, the median number of treatment cycles from its pivotal phase III clinical trial was used as treatment duration. Treatment costs were estimated for the modeled treatment duration considering therapy-specific dosing schedules and mean body surface area for Brazilian adult men/ women. Drug prices were based on December 2019 Brazilian list prices with 18% state tax (PF 18%). No vial sharing was assumed. Total treatment costs, cost per median overall survival (OS) and cost per complete response (CR) were compared.

RESULTS

Total treatment costs ranged from 585,601 to 1,054,081 BRL for inotuzumab ozogamicin depending on the mean body surface area (BSA) and treatment response; for blinatumomab the treatment cost presented up to 47% lower than inotuzumab ozogamicin (561,294 BRL) and the treatment cost didn’t vary for blinatumomab once for adult patients with weight greater than or equal to 45kg is considered a fixed-dose. In terms of cost per median OS blinatumomab presented up to 56% lower than inotuzumab ozogamicin (60,354 BRL versus 80,037-136,894 BRL). Similarly, the cost per achieved CR was lower for blinatumomab (1,521,123 BRL) than that for inotuzumab ozogamicin (1,839,660 – 3,146,510 BRL).

CONCLUSIONS

Results of the present analysis indicate that blinatumomab might be associated with considerably lower treatment costs. When cost analysis included efficacy data, blinatumomab presented lower cost per median OS and cost per CR than inotuzumab ozogamicin from the Brazilian private healthcare perspective.