CLINICAL AND ECONOMIC EVALUATION OF ATEZOLIZUMAB + VEMURAFENIB + COBIMETINIB COMBINATION AND NIVOLUMAB + IPILIMUMAB COMBINATION: ADMINISTRATION IN METASTATIC MELANOMA TREATMENT WITH BRAF-CONFIRMED MUTATION IN ADULT PATIENTS

The aim of the study was to conduct a pharmacoeconomic evaluation of the atezolizumab, vemurofenib and cobimetinib (ATZ+VM+COB) combination and the nivolumab and ipilimumab (NIVO+IPI) combination for the treatment of BRAF-confirmed metastatic melanoma in adult patients.Materials and methods. With th...

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Main Authors: I. S. Krysanov, E. V. Makarova, V. Yu. Ermakova
Format: Article
Language:Russian
Published: Volgograd State Medical University, Pyatigorsk Medical and Pharmaceutical Institute 2022-07-01
Series:Фармация и фармакология (Пятигорск)
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Online Access:https://www.pharmpharm.ru/jour/article/view/1120
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author I. S. Krysanov
E. V. Makarova
V. Yu. Ermakova
author_facet I. S. Krysanov
E. V. Makarova
V. Yu. Ermakova
author_sort I. S. Krysanov
collection DOAJ
description The aim of the study was to conduct a pharmacoeconomic evaluation of the atezolizumab, vemurofenib and cobimetinib (ATZ+VM+COB) combination and the nivolumab and ipilimumab (NIVO+IPI) combination for the treatment of BRAF-confirmed metastatic melanoma in adult patients.Materials and methods. With the help of mathematical modeling methods, a pharmacoeconomic “cost-effectiveness” analysis; a “budget impact” analysis; a sensitivity analysis to the changes in the initial parameters of the model, were carried out.Results. The analysis of literature sources made it possible to conclude that the combination of ATZ+VM+COB compared with the combination of NIVO+IPI (15.1 and 11.2 months, respectively) has a greater clinical efficacy in terms of a progression-free survival (PFS) in patients with metastatic melanoma. When choosing the ATZ+VM+COB combination, the total cost of treatment for one adult patient with metastatic melanoma per course was lower, compared to the NIVO+IPI combination (RUB 8 326 864.89 vs RUB 7 172 751.68); the difference amounted to 1 154 113.21 rubles. When calculating the “cost-effectiveness” ratio for a year of a progression-free survival, the advantage of the ATZ + VM + COB combination in comparison with the NIVO + IPI combination, remained (5 700 200.01 rubles vs 8 942 400.10 rubles); the difference amounted to 3 242 200.09 rubles. The sensitivity analysis demonstrated the developed model stability to an increase in the cost of the ATZ + VM + COB course up to + 16%, a decrease in the cost of the NIVO + IPI course to –13%, and a reduction in the PFS to –37% against the background of the ATZ + VM + COB course. The “budget impact” analysis showed the possibility of reducing costs by 8 655 849.11 rubles with an increase from 5% to 20% in the proportion of the patients administrated with the ATZ+VM+COB combination, and with a decrease from 95% to 80% in the proportion of the patients administrated with the NIVO+IPI combination.Conclusion. The results of the work have shown that within the healthcare system of the Russian Federation, the triple combination of ATZ+VM+COB is a clinically cost-effective option for the treatment of adult metastatic melanoma patients with a confirmed BRAF mutation.
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spelling doaj-art-df90d48bc7994232897b1cff85d595c62025-08-20T03:21:16ZrusVolgograd State Medical University, Pyatigorsk Medical and Pharmaceutical InstituteФармация и фармакология (Пятигорск)2307-92662413-22412022-07-0110327828810.19163/2307-9266-2022-10-3-278-288443CLINICAL AND ECONOMIC EVALUATION OF ATEZOLIZUMAB + VEMURAFENIB + COBIMETINIB COMBINATION AND NIVOLUMAB + IPILIMUMAB COMBINATION: ADMINISTRATION IN METASTATIC MELANOMA TREATMENT WITH BRAF-CONFIRMED MUTATION IN ADULT PATIENTSI. S. Krysanov0E. V. Makarova1V. Yu. Ermakova21. Moscow State University of Food Production 2. LLC “Institute of Clinical and Economic Expertise and Pharmacoeconomics” 3. A.I. Yevdokimov Moscow State University of Medicine and Dentistry1. A.I. Yevdokimov Moscow State University of Medicine and Dentistry 2. National Research Institute of Public Health named after N.A. Semashko1. LLC “Institute of Clinical and Economic Expertise and Pharmacoeconomics” 2. Sechenov First Moscow State Medical UniversityThe aim of the study was to conduct a pharmacoeconomic evaluation of the atezolizumab, vemurofenib and cobimetinib (ATZ+VM+COB) combination and the nivolumab and ipilimumab (NIVO+IPI) combination for the treatment of BRAF-confirmed metastatic melanoma in adult patients.Materials and methods. With the help of mathematical modeling methods, a pharmacoeconomic “cost-effectiveness” analysis; a “budget impact” analysis; a sensitivity analysis to the changes in the initial parameters of the model, were carried out.Results. The analysis of literature sources made it possible to conclude that the combination of ATZ+VM+COB compared with the combination of NIVO+IPI (15.1 and 11.2 months, respectively) has a greater clinical efficacy in terms of a progression-free survival (PFS) in patients with metastatic melanoma. When choosing the ATZ+VM+COB combination, the total cost of treatment for one adult patient with metastatic melanoma per course was lower, compared to the NIVO+IPI combination (RUB 8 326 864.89 vs RUB 7 172 751.68); the difference amounted to 1 154 113.21 rubles. When calculating the “cost-effectiveness” ratio for a year of a progression-free survival, the advantage of the ATZ + VM + COB combination in comparison with the NIVO + IPI combination, remained (5 700 200.01 rubles vs 8 942 400.10 rubles); the difference amounted to 3 242 200.09 rubles. The sensitivity analysis demonstrated the developed model stability to an increase in the cost of the ATZ + VM + COB course up to + 16%, a decrease in the cost of the NIVO + IPI course to –13%, and a reduction in the PFS to –37% against the background of the ATZ + VM + COB course. The “budget impact” analysis showed the possibility of reducing costs by 8 655 849.11 rubles with an increase from 5% to 20% in the proportion of the patients administrated with the ATZ+VM+COB combination, and with a decrease from 95% to 80% in the proportion of the patients administrated with the NIVO+IPI combination.Conclusion. The results of the work have shown that within the healthcare system of the Russian Federation, the triple combination of ATZ+VM+COB is a clinically cost-effective option for the treatment of adult metastatic melanoma patients with a confirmed BRAF mutation.https://www.pharmpharm.ru/jour/article/view/1120metastatic melanomabraf mutationsmelanoma treatment“cost-effectiveness” analysis“budget impact” analysisatezolizumabvemurafenibcobimetinib
spellingShingle I. S. Krysanov
E. V. Makarova
V. Yu. Ermakova
CLINICAL AND ECONOMIC EVALUATION OF ATEZOLIZUMAB + VEMURAFENIB + COBIMETINIB COMBINATION AND NIVOLUMAB + IPILIMUMAB COMBINATION: ADMINISTRATION IN METASTATIC MELANOMA TREATMENT WITH BRAF-CONFIRMED MUTATION IN ADULT PATIENTS
Фармация и фармакология (Пятигорск)
metastatic melanoma
braf mutations
melanoma treatment
“cost-effectiveness” analysis
“budget impact” analysis
atezolizumab
vemurafenib
cobimetinib
title CLINICAL AND ECONOMIC EVALUATION OF ATEZOLIZUMAB + VEMURAFENIB + COBIMETINIB COMBINATION AND NIVOLUMAB + IPILIMUMAB COMBINATION: ADMINISTRATION IN METASTATIC MELANOMA TREATMENT WITH BRAF-CONFIRMED MUTATION IN ADULT PATIENTS
title_full CLINICAL AND ECONOMIC EVALUATION OF ATEZOLIZUMAB + VEMURAFENIB + COBIMETINIB COMBINATION AND NIVOLUMAB + IPILIMUMAB COMBINATION: ADMINISTRATION IN METASTATIC MELANOMA TREATMENT WITH BRAF-CONFIRMED MUTATION IN ADULT PATIENTS
title_fullStr CLINICAL AND ECONOMIC EVALUATION OF ATEZOLIZUMAB + VEMURAFENIB + COBIMETINIB COMBINATION AND NIVOLUMAB + IPILIMUMAB COMBINATION: ADMINISTRATION IN METASTATIC MELANOMA TREATMENT WITH BRAF-CONFIRMED MUTATION IN ADULT PATIENTS
title_full_unstemmed CLINICAL AND ECONOMIC EVALUATION OF ATEZOLIZUMAB + VEMURAFENIB + COBIMETINIB COMBINATION AND NIVOLUMAB + IPILIMUMAB COMBINATION: ADMINISTRATION IN METASTATIC MELANOMA TREATMENT WITH BRAF-CONFIRMED MUTATION IN ADULT PATIENTS
title_short CLINICAL AND ECONOMIC EVALUATION OF ATEZOLIZUMAB + VEMURAFENIB + COBIMETINIB COMBINATION AND NIVOLUMAB + IPILIMUMAB COMBINATION: ADMINISTRATION IN METASTATIC MELANOMA TREATMENT WITH BRAF-CONFIRMED MUTATION IN ADULT PATIENTS
title_sort clinical and economic evaluation of atezolizumab vemurafenib cobimetinib combination and nivolumab ipilimumab combination administration in metastatic melanoma treatment with braf confirmed mutation in adult patients
topic metastatic melanoma
braf mutations
melanoma treatment
“cost-effectiveness” analysis
“budget impact” analysis
atezolizumab
vemurafenib
cobimetinib
url https://www.pharmpharm.ru/jour/article/view/1120
work_keys_str_mv AT iskrysanov clinicalandeconomicevaluationofatezolizumabvemurafenibcobimetinibcombinationandnivolumabipilimumabcombinationadministrationinmetastaticmelanomatreatmentwithbrafconfirmedmutationinadultpatients
AT evmakarova clinicalandeconomicevaluationofatezolizumabvemurafenibcobimetinibcombinationandnivolumabipilimumabcombinationadministrationinmetastaticmelanomatreatmentwithbrafconfirmedmutationinadultpatients
AT vyuermakova clinicalandeconomicevaluationofatezolizumabvemurafenibcobimetinibcombinationandnivolumabipilimumabcombinationadministrationinmetastaticmelanomatreatmentwithbrafconfirmedmutationinadultpatients