THE COST BURDEN OF TRASTUZUMAB AND BEVACIZUMAB THERAPY FOR SOLID TUMOURS IN CANADA

[摘要] Objective: Monoclonal antibodies (MAb), such as trastuzumab (TZ) and bevacizumab (BZ), have become important, yet expensive, components of systemic cancer therapy across a variety of disease sites. The potential cost implications of adopting TZ and BZ therapy were assessed in the context of their potential utilization in breast (BRC), lung (LUC) and colorectal (CRC) cancers. Design:MAb costs per patient, per treatment indication, were first estimated, and included MAb acquisition cost as well as costs of medical resource utilizations required for therapy delivery. Drug costs were based on 2005 average Canadian (Cdn) wholesale prices, assuming full drug delivery and uncomplicated cycles. A direct payer perspective was undertaken, and results are reported in Canadian dollars ($). Potential lifetime costs were then derived according to constructed schema, which account for absolute numbers of target patients and systemic therapy utilization. We subsequently estimated costs of MAb therapy relative to total costs of conventional management without MAb therapy. Results: TZ costs $49,915 and $28,350 per patient treated for adjuvant and metastatic BRC, respectively, while BZ costs $48,490 and $39,614 per patient treated for metastatic LUC and CRC, respectively. Potential lifetime absolute costs to Canada’s health care system were approximately $127 million and $299 million for TZ and BZ, respectively, corresponding to an average increase in health care expenditure of approximately 19% for BRC and 21% for LUC and CRC. Conclusions: MAb therapy, such as TZ and BZ, will likely add a significant cost burden to Canada’s publicly funded health care system.

[学科分类] 肿瘤学