Komarov Elijah Alexandrovich
Mantle cell lymphoma (MCL) accounts for approximately 2% to 10% of the total number of lymphatic system tumours, the incidence rate in Western Europe and Scandinavia is approximately 0,5/100 000 people. Most MCL cases are aggressive lymphomas, and overall survival is in the range of 3 to 5 years, while the disease is characterized by a short time to progression. The objective of this study was to determine the better treatment option between temsirolimus and ibrutinib in the treatment of MCL, in terms of pharmacoeconomic analysis, by means of comparative cost-effectiveness assessment. The cost-effectiveness results obtained in this temsirolimus versus ibrutinib comparative study demonstrated that ibrutinib therapy was associated with lower cost per effectiveness unit when life years gained and quality-adjusted life years were utilized as effectiveness criteria. Obtained budget impact analysis results revealed that ibrutinib therapy resulted in budget saving.
Although there have been improvements in the detection and treatment of breast cancer (BC) it remains the most common cancer in women and oneof the leading causes of death. In Western Europe and North America, breast cancer is the leading cause of death among women aged 35 to 54 years (20%), and the second leading cause of death in women aged over 55 years exceeded only by cardiovascular diseases. Breast cancer incidence increases with age, beginning from 40 years, with a peak at 60 to 65 years. The objective of this study was to determine, from the pharmacoeconomic point of view, the preferred treatment regimen (Kadcyla, lapatinib + capecitabine, trastuzumab + capecitabine, capecitabine), used in the treatment of HER2-positive breast cancer, on the basis of comparison of cost-effectiveness ratio, safety and life quality. The use of Kadcyla in the treatment of patients with HER2-positive breast cancer resulted in the highest values of life years gained and quality adjusted life years in comparison with lapatinib + capecitabine, trastuzumab + capecitabine, or capecitabine regimen. According to the results of the costeffectiveness analysis and cost-utility analysis it was found that the therapy with Kadcyla required higher costs to achieve LYG and QALY compared to those of the treatment regimens with the use of lapatinib + capecitabine, trastuzumab + capecitabine, and capecitabine, respectively. Incremental ratios in both analyses are higher than the willingness to pay threshold values for the Russian Federation.
Breast cancer (BC) is the most common type of cancer in women and one of the leading causes of death among women worldwide, including our country. According to the World Health Organization, over 11,000,000 women with diagnosed BC receive care and treatment worldwide. Each year approximately 1,200,000 new cases of breast cancer are registered and more than 500,000 women die, and it is estimated that the incidents will increase up to 1,450,000. The objective of this study was to determine a treatment regimen (pertuzumab+trastuzumab+docetaxel or placebo+trastuzumab+docetaxel) more advantageous from the pharmacoeconomic point of view, used in the treatment of HER2+ metastatic breast cancer (mBC), on the basis of comparison of costeffectiveness ratio, safety and life quality. The results of the cost-effectiveness analysis showed that cost-effectiveness ratios (effectiveness criterion – Life Years Gained, LYG) were as follows (over a period of 25 years: 1,823,530 rubles in the pertuzumab+trastuzumab+docetaxel group and 587,120 rubles in the placebo+trastuzumab+docetaxel group. The incremental costeffectiveness ratio for the health technologies compared was 8,150,535 rubles/LYG. The results of the cost-utility analysis showed that the cost-utility ratios (utility criterion – Quality Adjusted Life Years, QALY) were as follows (over a period of 25 years): 2,716,738 rubles in the pertuzumab+trastuzumab+docetaxel group and 908,787 rubles in the placebo+trastuzumab+docetaxel group. The incremental cost-effectiveness ratio for the health technologies compared was 10,187,748 rubles/QALY. The results of the budget impact analysis demonstrated that for the Perjeta-trastuzumab-docetaxel treatment regimen, the difference in the required budgetary funds was 5,711,668 rubles in comparison with the placebo-trastuzumab-docetaxel treatment regimen per treatment of one patient with BC (over a period of 25 years).
Main presentations and educational seminars which took place during Annual European congress of International Society For Pharmacoeconomics and Outcomes Research (ISPOR) are covered
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, which, in the cases of high activity, results in extensive damage to various tissues and organs, as well as promotes early patient disability. Most drugs used for the treatment of SLE are currently prescribed off-label, since this specific indication is not reflected in their prescribing information. At the same time, the advent of belimumab (Benlysta®), an innovative biological product for the treatment of SLE, which represents the most severe connective tissue disorder, provided patients with an access to a highly effective targeted therapy, which specifically impacts one of the main mechanisms of the disease. The innovative and proprietary product, Belimumab, has a relatively high cost, which, as the healthcare budget is restricted, requires that a pharmacoeconomic evaluation be completed of combined use of belimumab with standard of care (SoC) versus SoC alone. The present study showed that the use of belimumab combined with SoC in patients with SLE was, clearly, associated with additional costs compared to SoC alone. However, given low incidence of the condition, the overall increase in costs is unlikely to be significant. On the other hand, it was noted that the high belimumab efficacy resulted in lower direct costs of treating the SLE (cardiovascular, cutaneous, and pulmonary) complications, as well as the costs of hospital care. A comparative analysis has demonstrated that the annual cost of treatment with belimumab was similar to the cost of other genetically engineered biological products, which have already been included into the List of Vital and Essential Drugs used for rheumatic diseases, particularly rheumatoid arthritis. In this view, the use of belimumab, which represents the only targeted drug for SLE, could be considered during the review of policy for subsidised drug provision to patients with this condition.
Main presentations and educational seminars which took place during Annual European congress of International Society For Pharmacoeconomics and Outcomes Research (ISPOR) are covered
Mantle cell lymphoma (MCL) accounts for approximately 2% to 10% of the total number of lymphatic system tumours, the incidence rate in Western Europe and Scandinavia is approximately 0,5/100 000 people. Most MCL cases are aggressive lymphomas, and overall survival is in the range of 3 to 5 years, while the disease is characterized by a short time to progression. The objective of this study was to determine the better treatment option between temsirolimus and ibrutinib in the treatment of MCL, in terms of pharmacoeconomic analysis, by means of comparative cost-effectiveness assessment. The cost-effectiveness results obtained in this temsirolimus versus ibrutinib comparative study demonstrated that ibrutinib therapy was associated with lower cost per effectiveness unit when life years gained and quality-adjusted life years were utilized as effectiveness criteria. Obtained budget impact analysis results revealed that ibrutinib therapy resulted in budget saving.
Although there have been improvements in the detection and treatment of breast cancer (BC) it remains the most common cancer in women and oneof the leading causes of death. In Western Europe and North America, breast cancer is the leading cause of death among women aged 35 to 54 years (20%), and the second leading cause of death in women aged over 55 years exceeded only by cardiovascular diseases. Breast cancer incidence increases with age, beginning from 40 years, with a peak at 60 to 65 years. The objective of this study was to determine, from the pharmacoeconomic point of view, the preferred treatment regimen (Kadcyla, lapatinib + capecitabine, trastuzumab + capecitabine, capecitabine), used in the treatment of HER2-positive breast cancer, on the basis of comparison of cost-effectiveness ratio, safety and life quality. The use of Kadcyla in the treatment of patients with HER2-positive breast cancer resulted in the highest values of life years gained and quality adjusted life years in comparison with lapatinib + capecitabine, trastuzumab + capecitabine, or capecitabine regimen. According to the results of the costeffectiveness analysis and cost-utility analysis it was found that the therapy with Kadcyla required higher costs to achieve LYG and QALY compared to those of the treatment regimens with the use of lapatinib + capecitabine, trastuzumab + capecitabine, and capecitabine, respectively. Incremental ratios in both analyses are higher than the willingness to pay threshold values for the Russian Federation.
Breast cancer (BC) is the most common type of cancer in women and one of the leading causes of death among women worldwide, including our country. According to the World Health Organization, over 11,000,000 women with diagnosed BC receive care and treatment worldwide. Each year approximately 1,200,000 new cases of breast cancer are registered and more than 500,000 women die, and it is estimated that the incidents will increase up to 1,450,000. The objective of this study was to determine a treatment regimen (pertuzumab+trastuzumab+docetaxel or placebo+trastuzumab+docetaxel) more advantageous from the pharmacoeconomic point of view, used in the treatment of HER2+ metastatic breast cancer (mBC), on the basis of comparison of costeffectiveness ratio, safety and life quality. The results of the cost-effectiveness analysis showed that cost-effectiveness ratios (effectiveness criterion – Life Years Gained, LYG) were as follows (over a period of 25 years: 1,823,530 rubles in the pertuzumab+trastuzumab+docetaxel group and 587,120 rubles in the placebo+trastuzumab+docetaxel group. The incremental costeffectiveness ratio for the health technologies compared was 8,150,535 rubles/LYG. The results of the cost-utility analysis showed that the cost-utility ratios (utility criterion – Quality Adjusted Life Years, QALY) were as follows (over a period of 25 years): 2,716,738 rubles in the pertuzumab+trastuzumab+docetaxel group and 908,787 rubles in the placebo+trastuzumab+docetaxel group. The incremental cost-effectiveness ratio for the health technologies compared was 10,187,748 rubles/QALY. The results of the budget impact analysis demonstrated that for the Perjeta-trastuzumab-docetaxel treatment regimen, the difference in the required budgetary funds was 5,711,668 rubles in comparison with the placebo-trastuzumab-docetaxel treatment regimen per treatment of one patient with BC (over a period of 25 years).
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, which, in the cases of high activity, results in extensive damage to various tissues and organs, as well as promotes early patient disability. Most drugs used for the treatment of SLE are currently prescribed off-label, since this specific indication is not reflected in their prescribing information. At the same time, the advent of belimumab (Benlysta®), an innovative biological product for the treatment of SLE, which represents the most severe connective tissue disorder, provided patients with an access to a highly effective targeted therapy, which specifically impacts one of the main mechanisms of the disease. The innovative and proprietary product, Belimumab, has a relatively high cost, which, as the healthcare budget is restricted, requires that a pharmacoeconomic evaluation be completed of combined use of belimumab with standard of care (SoC) versus SoC alone. The present study showed that the use of belimumab combined with SoC in patients with SLE was, clearly, associated with additional costs compared to SoC alone. However, given low incidence of the condition, the overall increase in costs is unlikely to be significant. On the other hand, it was noted that the high belimumab efficacy resulted in lower direct costs of treating the SLE (cardiovascular, cutaneous, and pulmonary) complications, as well as the costs of hospital care. A comparative analysis has demonstrated that the annual cost of treatment with belimumab was similar to the cost of other genetically engineered biological products, which have already been included into the List of Vital and Essential Drugs used for rheumatic diseases, particularly rheumatoid arthritis. In this view, the use of belimumab, which represents the only targeted drug for SLE, could be considered during the review of policy for subsidised drug provision to patients with this condition.
