OBJECTIVES

To evaluate value of KANJINTI (an IV trastuzumab biosimilar) in patients with early (EBC) and metastatic breast cancer (mBC) by estimating the cost-effectiveness of KANJINTI vs. chemotherapy, budget impact (BI) of switching patients from chemotherapy to KANJINTI for patients whose insurance didn’t cover trastuzumab and impact of switching patients from Herceptin to KANJINTI from a Brazilian private healthcare perspective.

METHODS

Cost-effectiveness was evaluated via lifetime costs and life years gained estimated using a standard three-state partitioned survival model. The model used progression-free survival (PFS) and overall survival (OS) data from comparative phase III trials and supplemented data from literature. Costs pertaining to drug acquisition (based on recent list prices), administration, disease management and subsequent therapy were included. Results were discounted at 5% annually.

BI was evaluated in local population derived using epidemiological data from literature. Annual cost per patient to replace chemotherapy by KANJINTI and overall savings gained by switching from Herceptin to KANJINTI were calculated. Uncertainty was assessed using deterministic sensitivity analysis.

RESULTS

For EBC patients, incremental costs and LYs were R$ 123,715 and 1.83 resulting in an incremental cost effectiveness ratio (ICER) of R$ 67,609. Likewise, for mBC patients, these were R$ 136,661 and 1.32 yielding an ICER of R$ 103,373. Both ICERs are cost-effective (lower than WHO’s threshold of 3*GDP per capita R$ 106,350) and were sensitive to drug acquisition costs and clinical parameters used to model PFS and OS.

Switching patients from chemotherapy to KANJINTI resulted in additional cost of R$ 81,350 per patient annually. Savings generated by switching 3,990 patients from Herceptin to KANJINTI amounted to R$ 421,166,642.

CONCLUSIONS

Treatment with KANJINTI proved to be cost-effective and savings generated from patients switching from Herceptin to KANJINTI could be reinvested to allow Brazilian private health insurers to improve patient care.