BRENTUXIMAB VEDOTIN (ADCETRIS®) ECONOMIC EVALUATION ON PATIENT’S TREATMENT WITH RELAPSE OR REFRACTORY HODGKIN LINFOMA

OBJECTIVES: To assess the budget impact of brentuximab vedotin in patients with relapsed or refractory Hodgkin lymphoma (HL) from the perspective of México’s National Healthcare System (NHS). METHODS:  A budget impact analysis of brentuximab vedotin, an orphan drug for patients with relapsed or refractory HL, was conducted. The current treatment alternatives in Mexico include the following: 1) ICE (ifosfamide, carboplatin, etoposide), 2) MINE (mesna, Ifosfamide, mitoxantrone, etoposide) 3) ESHAP (etoposide, methylprednisolone, cytarabine, cisplatin), and 4) IGEV (ifosfamide, gemcitabine, vinorelbine). The analysis was performed from the institutional perspective, with a five year time horizon. Target population estimates were based on projections of the Mexican population reported by CONAPO (Consejo Nacional de Población) and HL incidence obtained from the literature. The direct costs were taken from institutional sources in 2016, primarily drug costs of the current treatment schemes of the NHS. The results are presented as the budget impact for the NHS and for each public healthcare institution (IMSS, ISSSTE, Seguro Popular, PEMEX, SEMAR, SEDENA). The results are also expressed as percentage of the total drug budget of the institutions. Finally, a univariate deterministic sensitivity analysis was conducted. RESULTS: The budget impact analysis shows that the incorporation of brentuximab vedotin to the NHS generates an incremental investment of $169,322 USD in 2016, reaching a total of $893,529 USD in 2020, with an average of 49 new patients annually. An annual average investment of $526,914 USD, or 0.016% of México NHS’s drug budget in 2016, will be required. CONCLUSIONS: Given the high mortality of relapsed or refractory HL, there is a need for alternative treatments for patients in this setting. Brentuximab vedotin is a viable treatment option with a limited budget impact affordable to the Mexico NHS.