Affiliation:
1. Financial Research Institute; Russian Presidential Academy of National Economy and Public Administration; Health and Market Access Consulting LLC
2. Financial Research Institute; Health and Market Access Consulting LLC
Abstract
Objective: to perform a cost-effectiveness analysis of using encorafenib and binimetinib combination in the first-line therapy for metastatic or unresectable BRAF V600-mutated melanoma in the Russian Federation. Material and methods. The comparators included “dabrafenib + trametinib” combination and vemurafenib monotherapy, which are listed in the Russian clinical guidelines and the Vital and Essential Drugs List. Since “encorafenib and binimetinib” combination demonstrated superior overall response rate compared to “dabrafenib + trametinib” and vemurafenib monotherapy, the method of cost-effectiveness analysis was used. We developed a disease progression model based on data from the COLUMBUS randomized control trial and published network meta-analysis. The model was used to calculate the direct medical costs associated with the considered alternatives over a 3-year modeling horizon. We compared the incremental cost-effectiveness ratio for “encorafenib + binimetinib” vs. “dabrafenib + trametinib” to the same ratio calculated for “dabrafenib + trametinib” vs. vemurafenib monotherapy.Results. Mean costs of using “encorafenib + binimetinib” combination over a 3-year period, considering the discontinuation of treatment as the disease progresses, was 6,547,693.07 rubles. Meanwhile, it was 5,962,742.52 rubles for “dabrafenib + trametinib” and 2,581,781.45 rubles for vemurafenib monotherapy. The incremental cost-effectiveness ratio of “encorafenib + binimetinib” vs. “dabrafenib + trametinib” was 3,846,818.71 rubles per 1 patient with a response to therapy. This was 85.14% lower than the same ratio estimated for “dabrafenib + trametinib” vs. vemurafenib monotherapy (25,890,022.64 rubles per 1 patient with a response to therapy).Conclusion. The “encorafenib + binimetinib” combination is a cost-effective treatment method for patients with unresectable or metastatic BRAF V600-mutated melanoma in the Russian Federation.
Subject
Public Health, Environmental and Occupational Health,Health Policy,Pharmacology
Reference25 articles.
1. Clinical guidelines “Skin melanoma and mucous membranes”, 2020. Available at: https://cr.minzdrav.gov.ru/recomend/546 (in Russ.) (accessed 10.08.2022).
2. Kaprin A.D., Starinskiy V.V., Shakhzadova A.O. The state of oncological care for the population of Russia in 2021. Мoscow: Herzen Moscow Research Oncological Institute – branch of the National Medical Research Center of Radiology; 2022: 239 pp. (in Russ.).
3. Kaprin A.D., Starinskiy V.V., Shakhzadova A.O. Malignant neoplasms in Russia in 2021 (morbidity and mortality).Мoscow: Herzen Moscow Research Oncological Institute – branch of the National Medical Research Center of Radiology; 2022: 252 pp. (in Russ.).
4. Yeremina Ye.N., Gavrilyuk D.V., Zukov R.A. Long-term combination targeted therapy for metastatic skin melanoma. Effective Pharmacotherapy. 2021; 17 (2): 74–8 (in Russ.).
5. Chapman P.B., Hauschild A., Robert C., et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation. New Engl J Med. 2011; 364 (26): 2507–16. https://doi.org/10.1056/NEJMoa1103782.