OBJECTIVES:

Blinatumomab, FLAG-IDA and HYPER CVAD are used in the treatment of adults with Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). The main objective is to do a budget impact analysis of the introduction of Blinatumomab compared to FLAG-IDA and HYPER CVAD from the perspective of the public health system in Mexico. A cost per response analysis versus FLAGIDA was developed as secondary analysis.

METHODS:

A time horizon of five years was used, considering the use of resources, direct medical costs and population characteristics to quantify the economic consequences of the introduction of Blinatumomab as a new therapeutic alternative in Mexico. A cost per response analysis was conducted considering the use of resources, response rates and number needed to treat (NNT) for both therapeutic treatments. Response rates were obtained from literature and were 73% for Blinatumomab and 32% for FLAGIDA. All costs are expressed in 2017 USD (exchange rate: 19.0137 MXN/USD).

RESULTS:

Considering a total budget of $3.5 billion for the Mexican public healthcare system, the introduction of Blinatumomab would require an average increment of 0.14981% for the first 5 years, generating an average cost of $5,204,192.

With a use of resources of $130,764 for Blinatumomab and $83,985 for FLAG IDA, we obtained a NNT of 1.37 for Blinatumumab and 3.13 for FLAG-IDA that turned out into a cost per response for Blinatumomab of $179,129 and $262,455 with FLAG-IDA

CONCLUSIONS:

The incorporation of Blinatumumab to the Mexican healthcare system, as a new therapeutic alternative would generate an average increment of 0.14981%, for the first 5 years, generating an average cost of $5,204,192 of the healthcare system budget. The cost per effectively treated patient turned out to be more expensive when using FLAG-IDA ($262,455) versus Blinatumomab ($179,129).