A BUDGET IMPACT ANALYSIS OF INTRODUCING A FORCED TREATMENT PATHWAY USING THE LOWEST PRICED ANTI-TUMOR NECROSIS FACTOR AGENT FOR RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDYLITIS IN THE PHILIPPINES
Author(s)
Tee M1, Tee CA2
1University of the Philippines, Pasong Tamo, Quezon City, Philippines, 2University of the Philippines, Manila, Philippines
OBJECTIVES: Currently, biologic agents are not included in the Philippine National Drug Formulary (the basis for the country’s insurance claims and reimbursements). The Philippine Charity Sweepstakes Office (PCSO) funds the purchase of anti-tumor necrosis factor (TNF) agents and budget use must be optimized to treat as many patients as possible. We used a budget impact analysis model to estimate the number of patients who could access biologics if a forced treatment pathway was applied to prioritize the lowest-priced anti-TNF agent. METHODS: The model compared patient numbers served using historical PCSO purchase data with the number of potential patients who could have been served if a forced pathway was applied, whereby all patients received the lowest priced anti-TNF for 6 months, with 60% of patients staying on treatment for the remaining year and 40% switching to etanercept or golimumab due to poor response. The number of equivalent patient years (EPY) provided by PCSO from 2012–2017 was calculated using the actual purchase scenario and compared with the EPY that the fund could have provided had it followed the forced pathway. RESULTS: The 2012 PCSO fund (Philippine pesos [PHP] Using the forced pathway, the 2016 and 2017 budgets could have provided treatment for 482 and 677 EPY, respectively. CONCLUSIONS: Introduction of a forced treatment pathway using the lowest priced anti-TNF for the first 6 months will allow more patients access to treatment.
Conference/Value in Health Info
2018-11, ISPOR Europe 2018, Barcelona, Spain
Value in Health, Vol. 21, S3 (October 2018)
Code
PMS19
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Musculoskeletal Disorders