Budget Impact of Alectinib in The Treatment of Naïve Anaplastic Lymphoma Kinase-Positive (ALK+) Advanced Non-Small Cell Lung Cancer (NSCLC) in Greece

• Published in: Value in health 2017-10, Vol.20 (9), p.A424
• Main Authors: Kourkoulas, N, Kyriopoulos, D, Athanasakis, K
• Format: Article
• Language: English
• Subjects: Budgets; Central nervous system; Chemotherapy; Clinical effectiveness; Drug therapy; First year; Health care industry; Health care policy; Health insurance; Impact analysis; Lung cancer; Lymphoma; Market shares; Non-small cell lung carcinoma; Oncologists; Patients; Protein-tyrosine kinase; Social security
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.151

OBJECTIVES: Lung cancer poses a considerable disease and economic burden on healthcare systems globally. Alectinib, a highly selective, CNS-active anaplastic lymphoma kinase (ALK) inhibitoris a new treatment option for 5% of Non-Small Cell Lung Cancer (NSCLC) patients who carry mutations associated with ALK. The objective of this analysis is to estimate the potential budgetary impact of the introduction of Alectinib as a 1st line treatment approach in ALK+ NSCLC patients in the Greek healthcare setting. METHODS: The analysis was based on a budget impact model considering the market shares and price of Alectinib as a 1st line treatment approach in ALK+ NSCLC patients compared to Crizotinib, Ceritinib and chemotherapy The model was populated with epidemiological and clinical effectiveness data from the literature and Greek-specific inputs on health resource use, based on an expert panel of 10 oncologists. The analysis followed a third party payer perspective (Greek Social Insurance). RESULTS: 109 patients are estimated to be the ALK+ NSCLC in Greece per year. The gradual introduction of Alectinib as a treatment for na'ive ALK+ NSCLC patients (first year market share 3%, fifth year 60%) is projected to result in an annual incremental budget impact of €71,371, €454,469, €1,245,170, (2,699,802 and €4,161,658 for year one to five respectively, compared to the "world without" scenario. The cumulative budget impact (€8,632,470 for the five year time horizon of the analysis) is sensitive to the price of Alectinib (and its comparators) and the projected market shares. CONCLUSIONS: Based on the available epidemiological data for Greece, 5100 patients are diagnosed with NSCLC, of which 109 are eligible for treatment with an ALK inhibitor such as Alectinib. Owing mostly to the small number of patients, the budget impact of the introduction of Alectinib is reasonable.