Evidence map›Paper›PMID 33506317›Full record

ArticleApplied health economics and health policy2021

The Budget Impact of Monoclonal Antibodies Used to Treat Metastatic Colorectal Cancer in Minas Gerais, Brazil.

Wânia Cristina da Silva, Brian Godman, Francisco de Assis Acúrcio, Mariângela Leal Cherchiglia, Antony Martin, Konrad Maruszczyk, Jans Bastos Izidoro, Marcos André Portella, Agner Pereira Lana, Orozimbo Henriques Campos Neto and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Applied health economics and health policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 52% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 5 countries.

Wânia Cristina da SilvaPostgraduate Program in Medicines and Pharmaceutical Services, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil. wania_logistica@hotmail.com.ORCID 0000-0002-5108-5724
Brian GodmanStrathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.ORCID 0000-0001-6539-6972
Francisco de Assis AcúrcioPostgraduate Program in Medicines and Pharmaceutical Services, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.ORCID 0000-0002-5880-5261
Mariângela Leal CherchigliaPostgraduate Program in Medicines and Pharmaceutical Services, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.ORCID 0000-0001-5622-567X
Antony MartinHealth Economics Centre, University of Liverpool Management School, Liverpool, UK.ORCID 0000-0003-4383-6038
Konrad MaruszczykHealth Economics Services, Warsaw, Poland.
Jans Bastos IzidoroDivisão de Medicamentos Essenciais, Departamento de Assistência Farmacêutica, Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte, Brazil.
Marcos André PortellaMario Penna Institute of Oncology-Minas Gerais, Belo Horizonte, Brazil.
Agner Pereira LanaPostgraduate Program in Public Health, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Orozimbo Henriques Campos NetoAssociate Professor of Undergraduate Pharmacy, Faculdade Ciências da Vida (FCV), Sete Lagoas, Brazil.ORCID 0000-0001-6415-3709
Eli Iola Gurgel AndradePostgraduate Program in Medicines and Pharmaceutical Services, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.ORCID 0000-0002-0206-2462
Universidade Federal de Minas Gerais · BRCentro Universitário de Sete Lagoas · BRKarolinska University Hospital · SESecretaria da Saúde · BRSGH Warsaw School of Economics · PLUniversity of Liverpool · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBiological medicines have increased the cost of cancer treatments, which also raises concerns about sustainability. In Brazil, three monoclonal antibodies (mAbs)-bevacizumab, cetuximab, and panitumumab-are indicated for the treatment of metastatic colorectal cancer (mCRC) but not currently funded by the Unified Health System (SUS). However, successful litigation has led to funding in some cases.

objectiveOur objective was to evaluate the budgetary impact of including the mAbs bevacizumab, cetuximab, and panitumumab in standard chemotherapy for the treatment of mCRC within the SUS of Minas Gerais (MG), Brazil.

methodA budget impact analysis of incorporating mAbs as first-line treatment of mCRC in MG was explored. The perspective taken was that of the Brazilian SUS, and a 5-year time horizon was applied. Data were collected from lawsuits undertaken between January 2009 and December 2016, and the model was populated with data from national databases and published sources. Costs are expressed in $US.

resultsIn total, 351 lawsuits resulted in funding for first-line treatment with mAbs for mCRC. The three alternative scenarios analyzed resulted in cost increases of 348-395% compared with the reference scenario. The use of panitumumab had a budgetary impact of $US103,360,980 compared with the reference scenario over a 5-year time horizon, and bevacizumab and cetuximab had budgetary impacts of $US111,334,890 and 113,772,870, respectively. The use of the anti-epidermal growth factor receptor (EGFR) mAbs (cetuximab and panitumumab) is restricted to the approximately 41% of patients with KRAS mutations, so the best cost alternative for incorporation would be the combination of panitumumab and bevacizumab, with a cost of approximately $US106 million.

conclusionThese results highlight the appreciable costs for incorporating bevacizumab, cetuximab, and panitumumab into the SUS. Appreciable discounts are likely to be necessary before incorporation of these mAbs is approved.

Indexed as

Antibodies, MonoclonalColorectal NeoplasmsHealth Care CostsBrazilCost-Benefit AnalysisHumansPanitumumabAntibodies, MonoclonalPanitumumab

Identifiers

PMID33506317
OpenAlexW3108204080

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.