OBJECTIVES: In the Mexican public healthcare (PHC) system, there are few alternatives for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) progressing after treatment with docetaxel. However, healthcare payers are interested in quantifying the budget impact of these therapies. This analysis estimates the budget impact of enzalutamide as an alternative treatment for PHC patients in the Mexican Social Security Institute (IMSS).

METHODS: A model was developed to assess the budget impact of enzalutamide for the treatment of patients with mCRPC after docetaxel progression. Epidemiological data from the National Cancer Institute 2017, Lopez 2016, and Drake 2016 were used to estimate the number of patients in Mexico (i.e. 12 million men aged >40 years). Dosing, administration, duration of therapy, and adverse event rates were based on product labels and published clinical trial results. Drug costs were obtained from local direct medical costs and sales pricing files. Costs of administration and monitoring were obtained from the IMSS website and the published literature. Market shares were estimated for each comparator before and after adoption of enzalutamide. The incremental aggregate budget impact, per patient per year, was calculated.

RESULTS: The annual cost of one patient treated with enzalutamide in the Mexican PHC system was estimated at MX$528,862. The epidemiological model predicted that 39 patients would be eligible for treatment with enzalutamide in 1 year, resulting in an overall annual budget impact of MX$20.6 million, which represents a 0.04% impact on the total annual budget for pharmaceutical purchases.

CONCLUSIONS: Due to the absence of a therapeutic alternative for patients with mCRPC after progression on docetaxel, the introduction of enzalutamide is an affordable option for IMSS in Mexico.