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- Title
The application of pharmacoeconomic modelling to estimate a value-based price for new cancer drugs.
- Authors
Dranitsaris, George; Truter, Ilse; Lubbe, Martie S.; Cottrell, Wayne; Spirovski, Biljana; Edwards, Jonathan
- Abstract
Rationale, aims and objectives Value-based pricing has recently been discussed by international bodies as a means to estimate a drug price that is linked to the benefits it offers patients and society. The World Health Organization (WHO) has recommended using three times a country's per capita gross domestic product (GDP) as the threshold for economic value. Using the WHO criteria, pharmacoeconomic modelling was used to illustrate the application of value-based price towards bevacizumab, a relatively new drug that provides a 1.4-month survival benefit to patients with metastatic colorectal cancer (mCRC). Methods A decision model was developed to simulate outcomes in mCRC patients receiving chemotherapy ± bevacizumab. Clinical data were obtained from randomized trials and costs from Canadian cancer centres. Utility estimates were determined by interviewing 24 oncology nurses and pharmacists. A price per dose of bevacizumab was then estimated using a target threshold of $CAD117 000 per quality adjusted life year gained, which is three times the Canadian per capita GDP. Results For a 1.4-month survival benefit, a price of $CAD830 per dose would be considered cost-effective from the Canadian public health care perspective. If the drug were able to improve patient quality of life or survival from 1.4 to 3 months, the drug price could increase to $CAD1560 and $CAD2180 and still be considered cost-effective. Discussion The use of the WHO criteria for estimating a value-based price is feasible, but a balance between what patients/governments can afford to pay and the commercial viability of the product in the reference country would be required.
- Subjects
CANADA; DRUGS &; economics; ANTINEOPLASTIC agents; MONOCLONAL antibodies; COLON tumors; COST effectiveness; DECISION making; MEDICAL care costs; NEOVASCULARIZATION inhibitors; QUALITY of life; RECTUM tumors; SURVIVAL analysis (Biometry); PHARMACY; RANDOMIZED controlled trials; DISEASE progression; STATISTICAL models; ECONOMICS
- Publication
Journal of Evaluation in Clinical Practice, 2012, Vol 18, Issue 2, p343
- ISSN
1356-1294
- Publication type
Article
- DOI
10.1111/j.1365-2753.2010.01565.x