IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0146551.html
   My bibliography  Save this article

Comparative Cost-Effectiveness of Drugs in Early versus Late Stages of Cancer; Review of the Literature and a Case Study in Breast Cancer

Author

Listed:
  • Evgeni Dvortsin
  • Judith Gout-Zwart
  • Ernst-Lodewijk Marie Eijssen
  • Jan van Brussel
  • Maarten J Postma

Abstract

Background: Many oncological drugs that are being used in the adjuvant setting were first submitted for reimbursement in the metastatic stage, with differences in incremental cost-effectiveness ratios (ICERs) in both settings having potential implications for reimbursement and pricing. The aim of this study is to identify a possible trend in the cost-effectiveness for the early/adjuvant and late/metastatic stages of oncological drugs through review and case study. Methods: We reviewed pairs of cost-effectiveness analyses of the same oncological drug in different stages for Scotland and the Netherlands. The case study in this report was directed at trastuzumab in the Dutch situation. Using a simplified Markov model, the cost-effectiveness in early and late stage of breast cancer was calculated and compared to the findings from the review. Results: Comparable studies were found for cetuximab, bortezomib and bosutinib. Treatments in the late stage were found to be more expensive per QALY by a factor ranging from 1.5 to 12. The case study provided a similar result; late stage treatment was more expensive by a factor 10. Using, for example, a threshold of €80,000/QALY, the early stage of cetuximab, bosutinib and trastuzumab are deemed cost-effective, while their compared late stage is lifted over the threshold and potentially considered not cost-effective. Conclusion: ICERs of oncological drugs used in different stages are more unfavourable in the late stage than in the early stage. Applying a reasonable threshold may result in early stage treatment being deemed cost-effective while late stage potentially not. Authorities should be aware of this when assessing oncological drugs and interpreting the corresponding ICERs, in the situation where oncological drugs are generally most submitted for reimbursement in the late stage initially.

Suggested Citation

  • Evgeni Dvortsin & Judith Gout-Zwart & Ernst-Lodewijk Marie Eijssen & Jan van Brussel & Maarten J Postma, 2016. "Comparative Cost-Effectiveness of Drugs in Early versus Late Stages of Cancer; Review of the Literature and a Case Study in Breast Cancer," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-12, January.
    • Handle: RePEc:plo:pone00:0146551
    DOI: 10.1371/journal.pone.0146551
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0146551
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0146551&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0146551?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Malek B Hannouf & Chander Sehgal & Jeffrey Q Cao & Joseph D Mocanu & Eric Winquist & Gregory S Zaric, 2012. "Cost-Effectiveness of Adding Cetuximab to Platinum-Based Chemotherapy for First-Line Treatment of Recurrent or Metastatic Head and Neck Cancer," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-9, June.
    2. Carlson, Josh J. & Sullivan, Sean D. & Garrison, Louis P. & Neumann, Peter J. & Veenstra, David L., 2010. "Linking payment to health outcomes: A taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers," Health Policy, Elsevier, vol. 96(3), pages 179-190, August.
    3. Bonny Parkinson & Sallie-Anne Pearson & Rosalie Viney, 2014. "Economic evaluations of trastuzumab in HER2-positive metastatic breast cancer: a systematic review and critique," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 93-112, January.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Vincent T Janmaat & Marco J Bruno & Suzanne Polinder & Sylvie Lorenzen & Florian Lordick & Maikel P Peppelenbosch & Manon C W Spaander, 2016. "Cost-Effectiveness of Cetuximab for Advanced Esophageal Squamous Cell Carcinoma," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-10, April.
    2. Marcelien H. E. Callenbach & Rick A. Vreman & Aukje K. Mantel-Teeuwisse & Wim G. Goettsch, 2022. "When Reality Does Not Meet Expectations—Experiences and Perceived Attitudes of Dutch Stakeholders Regarding Payment and Reimbursement Models for High-Priced Hospital Drugs," IJERPH, MDPI, vol. 20(1), pages 1-12, December.
    3. Fernando Antonanzas & Carmelo Juárez-Castelló & Reyes Lorente & Roberto Rodríguez-Ibeas, 2019. "The Use of Risk-Sharing Contracts in Healthcare: Theoretical and Empirical Assessments," PharmacoEconomics, Springer, vol. 37(12), pages 1469-1483, December.
    4. Morgan, Steven G. & Thomson, Paige A. & Daw, Jamie R. & Friesen, Melissa K., 2013. "Canadian policy makers’ views on pharmaceutical reimbursement contracts involving confidential discounts from drug manufacturers," Health Policy, Elsevier, vol. 112(3), pages 248-254.
    5. Andrew M. Jones (ed.), 2012. "The Elgar Companion to Health Economics, Second Edition," Books, Edward Elgar Publishing, number 14021, March.
    6. Dunlop, William C.N. & Staufer, Alexandra & Levy, Pierre & Edwards, Guy J., 2018. "Innovative pharmaceutical pricing agreements in five European markets: A survey of stakeholder attitudes and experience," Health Policy, Elsevier, vol. 122(5), pages 528-532.
    7. repec:bla:glopol:v:8:y:2017:i:s2:p:46-59 is not listed on IDEAS
    8. Reza Mahjoub & Fredrik Ødegaard & Gregory S. Zaric, 2018. "Evaluation of a pharmaceutical risk‐sharing agreement when patients are screened for the probability of success," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 15-25, January.
    9. Bognar, Katalin & Romley, John A. & Bae, Jay P. & Murray, James & Chou, Jacquelyn W. & Lakdawalla, Darius N., 2017. "The role of imperfect surrogate endpoint information in drug approval and reimbursement decisions," Journal of Health Economics, Elsevier, vol. 51(C), pages 1-12.
    10. Ferrario, Alessandra & Kanavos, Panos, 2015. "Dealing with uncertainty and high prices of new medicines: A comparative analysis of the use of managed entry agreements in Belgium, England, the Netherlands and Sweden," Social Science & Medicine, Elsevier, vol. 124(C), pages 39-47.
    11. Elodie Adida, 2021. "Outcome-Based Pricing for New Pharmaceuticals via Rebates," Management Science, INFORMS, vol. 67(2), pages 892-913, February.
    12. Bonny Parkinson & Catherine Sermet & Fiona Clement & Steffan Crausaz & Brian Godman & Sarah Garner & Moni Choudhury & Sallie-Anne Pearson & Rosalie Viney & Ruth Lopert & Adam Elshaug, 2015. "Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review," PharmacoEconomics, Springer, vol. 33(9), pages 905-924, September.
    13. Goldman Dana P. & Lakdawalla Darius N. & Baumgardner James R. & Linthicum Mark T., 2016. "Are Biopharmaceutical Budget Caps Good Public Policy?," The Economists' Voice, De Gruyter, vol. 13(1), pages 27-42, December.
    14. Simon Walker & Mark Sculpher & Karl Claxton & Steve Palmer, 2012. "Coverage with evidence development, only in research, risk sharing or patient access scheme? A framework for coverage decisions," Working Papers 077cherp, Centre for Health Economics, University of York.
    15. Pace, Jessica & Ghinea, Narcyz & Kerridge, Ian & Lipworth, Wendy, 2018. "An ethical framework for the creation, governance and evaluation of accelerated access programs," Health Policy, Elsevier, vol. 122(9), pages 984-990.
    16. Paula K Lorgelly, 2018. "The Impact of Brexit on Pharmaceuticals and HTA," PharmacoEconomics - Open, Springer, vol. 2(2), pages 87-91, June.
    17. Lou Garrison;Ruth Puig-Peiro;Adrian Towse, 2012. "The Use of Pay-for-Performance for Drugs: Can It Improve Incentives for Innovation?," Occasional Paper 000167, Office of Health Economics.
    18. Haitham W. Tuffaha & Paul A. Scuffham, 2018. "The Australian Managed Entry Scheme: Are We Getting it Right?," PharmacoEconomics, Springer, vol. 36(5), pages 555-565, May.
    19. Josh Carlson & Katie Gries & Kai Yeung & Sean Sullivan & Louis Garrison, 2014. "Authors’ Reply to Curto and Garattini: “Current Status and Trends in Performance-Based Risk-Sharing Arrangements Between Healthcare Payers and Medical Product Manufacturers”," Applied Health Economics and Health Policy, Springer, vol. 12(5), pages 567-568, October.
    20. Marc Berger & David Grainger, 2010. "Comparative Effectiveness Research," PharmacoEconomics, Springer, vol. 28(10), pages 915-922, October.
    21. Andersson, Emelie & Svensson, Johanna & Persson, Ulf & Lindgren, Peter, 2020. "Risk sharing in managed entry agreements—A review of the Swedish experience," Health Policy, Elsevier, vol. 124(4), pages 404-410.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0146551. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.