BUDGET IMPACT ANALYSIS OF VANDETANIB FOR THE TREATMENT OF MEDULLARY THYROID CANCER IN PATIENTS WITH UNRESECTABLE LOCALLY ADVANCED OR METASTATIC DISEASE

Context: Medullary thyroid carcinoma (MTC), a malignancy of the parafollicular C cells of the thyroid gland, accounts for approximately 5% to 8% of all thyroid cancers (1,2,3). Total thyroidectomy is the most successful treatment option for early disease onset, but there are few options for the metastatic form with an unmet need for safe therapies with robust clinical evidence (4). Vandetanib is the only systemic therapy with ANVISA approval and clinical evidence from a phase III study for this indication. Objective: Evaluate the budget impact of vandetanib in the treatment of medullary thyroid cancer (MTC) in patients with unresectable locally advanced or metastatic disease for the Brazilian Supplementary Health System (SSS). Methods: A budget impact analysis was performed during a time horizon of five years (20202024) from the SSS perspective. The target population was calculated considering: 1) the local adult population (≥18 years old); 2) incidence of thyroid cancer; 3) rate of medullary thyroid cancer; 4) population with advanced /metastatic medullary thyroid cancer; and 5) population with advanced / metastatic medullary thyroid cancer in the SSS. The annual treatment cost was calculated by multiplying the monthly cost by 12 (months). The median time of progression-free survival (PFS), according to the ZETA study (5), estimated in 30.5 months, was used to calculate the total cost of treatment. The vandetanib market share growth was assumed to be: 10%, 20%, 30%, 40%, 50%, over 5 years consecutively, assuming all patients are currently treated with best supportive care (BSC). Results: The number of patients eligible for vandetanib was estimated to be 14 in the first year and 15 in the end of year 5. The total annual cost of treatment with vandetanib is BRL 611, 024.80. The reimbursement of vandetanib in the SSS will have a total budget impact of, approximately, BRL 9.98 million over 5 years which represents an increase of BRL 0.27 per beneficiary of ANS. Conclusions: Because of the low number of patients eligible for this treatment, the incorporation of vandetanib will represent a low impact considering the total number of beneficiary of Brazilian SSS. In addition, vandetanib is the only option for patients with MTC unresectable locally advanced or metastatic.

 

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Publikationsverlauf

Artikel online veröffentlicht:
23. Oktober 2019