OBJECTIVES : This study aimed to evaluate the budget impact of the newly approved ovarian cancer targeted therapy niraparib and olaparib in patients with platinum sensitive, recurrent ovarian cancer from a US third party payer perspective.

METHODS : We constructed a budget impact model to assess the additional per member per month (PMPM) cost associated with the introduction of niraparib and olaparib, two PARP inhibitors that were recently approved to be used in platinum sensitive, recurrent ovarian cancer patients with and without BRCA mutation. The model assessed both pharmacy costs and medical costs. Pharmacy costs included both the costs of companion diagnosis test as well as the drug costs. Medical costs included disease monitoring, treatment associated costs and mitigation of adverse events. Epidemiological data from literature were used to estimate the target population size. The analysis used one-year time frame and patients were assumed on treatment until disease progression or death. Clinical trials data were used for drug dose adjustment. All costs were computed in 2017 USD. One-way sensitivity analysis were conducted to evaluate model robustness.

RESULTS : In a hypothetical plan of 1,000,000 members, 206 patients were estimated to be potential candidates for niraparib or olaparib treatment. At a listed WAC price of $14,750 for niraparib and $13,482 for olaparib, the two PARP inhibitors have an overall budget impact of $0.31/PMPM, most of which were contributed by pharmacy costs. Sensitivity analyses suggested that assumptions around rate of copayment/coinsurance and market share impacted results.

CONCLUSIONS : Despite of the relatively high drug acquisition costs, adopting niraparib and olaparib may only have a modest impact on total budget increase.