Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;19(4):557-577.
doi: 10.1007/s40258-020-00626-0. Epub 2021 Jan 28.

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

Wânia Cristina da Silva  1 , Brian Godman  2   3   4   5 , Francisco de Assis Acúrcio  6   7 , Mariângela Leal Cherchiglia  6   7 , Antony Martin  4 , Konrad Maruszczyk  8 , Jans Bastos Izidoro  9 , Marcos André Portella  10 , Agner Pereira Lana  7 , Orozimbo Henriques Campos Neto  11 , Eli Iola Gurgel Andrade  6   7
Affiliations
Free article

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

Wânia Cristina da Silva et al. Appl Health Econ Health Policy. 2021 Jul.
Free article

Abstract

Introduction: Biological 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.

Objective: Our 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.

Method: A 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.

Results: In 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.

Conclusion: These 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.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA. 2018;68(6):394–424.
    1. Silva ACB, Vicentini MFB, Mendoza EZ, Fujiki FK, da Fonseca LG, Braghiroli M, et al. Young-age onset colorectal cancer in Brazil: analysis of incidence, clinical features, and outcomes in a tertiary cancer center. Curr Probl Cancer. 2019;43(5):477–86. - PubMed
    1. Souza DL, Jerez-Roig J, Cabral FJ, de Lima JR, Rutalira MK, Costa JA. Colorectal cancer mortality in Brazil: predictions until the year 2025 and cancer control implications. Dis Colon Rectum. 2014;57(9):1082–9. - PubMed
    1. Guerra MR, Bustamante-Teixeira MT, Corrêa CSL, Abreu DMXd, Curado MP, Mooney M, et al. Magnitude and variation of the burden of cancer mortality in Brazil and Federation Units, 1990 and 2015. Rev Bras Epidemiol. 2017;20(Suppl 01):102–15.
    1. Silva DAS, Tremblay MS, Souza MdFMd, Mooney M, Naghavi M, Malta DC. Mortality and years of life lost by colorectal cancer attributable to physical inactivity in Brazil (1990–2015): Findings from the Global Burden of Disease Study. PloS One. 2018;13(2):e0190943-e.