engleski

Comparing the cost of novel cancer treatment

Background: In assessing the price of any drug treatment, an issue of incomparability occurs. Customarily used DDD has not been able to overcome this issue. To assess the costs of novel cancer treatments, we were challenged to develop a new methodology. Methods: ATC classification was used for finding antineoplastic agents and endocrine therapy (ATC L01 or L02). For drugs matching this criterion designated for adults’ use approved by Centralised Marketing Authorisation in the last 15 years, we collected Summary of Products Characteristics (SPC). Firstly, we selected the monthly dose according to the existing DDD. If DDD not defined, we selected the SPC maintenance dose of a drug. Secondly, for drugs that did not have a single maintenance dose, we calculated the average. Thirdly, for drugs that had the recommended dose for the different indications, an average was calculated. The doses taken into account were for the drugs used as a monotherapy. If a drug was used as a part of combination therapy, we calculated only the average dose of a novel drug. We used the average adult’s body weight and the body surface when dosage depended on it. Prices were extracted from Slovenian Medicinal Products Database. If a single package with monthly therapy (28*DDD) did not exist, we calculated monthly costs by the average drug unit price. If a package matching SPC maintenance dose existed, we used that price. Results: We have recognised six principles for dose calculation and three principles for price calculation allowing us to calculate the average monthly cost. Conclusions: It is a Holy Grail of pharmacoeconomy to create a universal method for comparing the costs of different treatments. Our method showed a great spread among monthly costs, and by using this results, one could get a glimpse into the trend. It has some limitations, such as not taking into account the overall treatment duration depending on cancer type, acute or chronic administration and other drugs in combination therapy. Key messages: From the pharmacoeconomic point of view, a need for comparing cost of novel cancer treatment is emerging but known methods are insufficient for comparison of cost of many treatments. Recognised principles for dose and price calculation are a step towards creating a universal method for comparing the cost of different cancer treatments.

cost ; cancer treatment ; pharmacoeconomics

nije evidentirano