Review of pharmacoeconomic studies of melanoma treatment for the period 2018–2023

Author:

Kokushkin K. A.1ORCID,Zhuravleva M. V.2ORCID,Byakhov M. Y.3ORCID,Luchinin E. A.4ORCID,Luchinina E. V.4ORCID

Affiliation:

1. Clinical and Economic Analysis Scientific-Practical Center

2. I.M. Sechenov First Moscow State Medical University (Sechenov University); Scientific Centre for Expert Evaluation of Medicinal Products

3. Center for Outpatient Oncological Care, Central City Clinical Hospital

4. Saratov State Medical University n.a. V.I. Razumovsky

Abstract

When analyzing pharmacoeconomic studies of the skin melanoma treatment conducted in various countries, the combinations of vemurafenib + cobimetinib and encorafenib + binimetinib are the most acceptable therapy options in terms of increasing life expectancy with adjustments for quality, but, according to the clinical guidelines of the National Joint Oncology Network (NCCN), USA, version 2.2023 – “Melanoma: Cutaneous”, not for adjuvant therapy. At the same time, social networks can be a valuable asset of information about patient’s quality of the life. For the patients with advanced melanoma with a BRAF mutation, the combination of atezolizumab + vemurafenib + cobimetinib indicated the highest clinical effectiveness and can be recommended for pharmacotherapy under condition of drug price reduction.Comparison various drugs combinations with monotherapy for patients with unresectable or metastatic melanoma with a positive BRAF V600 mutation indicated that nivolumab + ipilimumab therapy is not cost-effective in comparison with nivolumab monotherapy, but combination of dabrafenib + trametinib, on the contrary, increases the patient's life expectancy compared to vemurafenib and it’s more cost-effective. It was shown that Pembrolizumab to increase life expectancy but it’s associated with increased costs compared to ipilimumab when comparing different monotherapy options. The assumed additional cost-effectiveness factor is acceptable for most European countries, because it does not exceed the “willingness to pay” threshold. It is necessary to conduct large-scale pharma-economic studies in order to identify the most cost-effective treatment for Russia for various variants of the course of melanoma, both of various combined regimens with each other, and their comparison with monotherapy. It is important to take into account also the costs of correcting undesirable adverse drug reactions, since they have a significant impact to the structure of direct costs. The development of innovative drugs for the treatment of melanoma is proceeding rapidly, however, access to these drugs is limited due to their high cost. Patient-centred drug development and reimbursement options need to be found.

Publisher

Rostov State Medical University

Subject

General Medicine

Reference45 articles.

1. Association of Oncologists of Russia, Association of Melanoma Specialists, All-Russian Public Organization “Russian Society of Clinical Oncology”, Approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation. Clinical guidelines Melanoma of the skin and mucous membranes. 2020.

2. Zhukovets A.G. Modern principles and prospects for the treatment of skin melanoma // Journal of Oncology. 2015; v.9 No. 4 (36): 69-76.

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4. Polyakova K. I., Holovnya-Voloskova M. E., Byakhov M. Yu., Ermolaeva T. N., Fisun A. G., Dubovtseva V. A., Olyushina E. M., Davydovskaya M. V., Kokushkin K. A. Comparative analysis of the cost of drug therapy for the most expensive oncological diseases in the city of Moscow // Malignant tumors. 2018; 8(2): 12-20. DOI: 10.18027/2224–5057–2018–8–2–12–20

5. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Melanoma: Cutaneous Version 2.2023 © 2023 National Comprehensive Cancer Network, Inc; 2023. Available at: NCCN.org. Accessed 6.24.2023. To view the most recent and complete version of the NCCN Guidelines®, go online to NCCN.org.

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