Determination of incremental cost-effectiveness ratios of antitumor drugs

DOI: https://doi.org/10.29296/25419218-2021-01-07
Issue: 
1
Year: 
2021

T.S. Teptsova(1) , K.A. Perova(1) , N.Z. Musina(1-4), V.V. Omelyanovsky(1, 4, 5), G.R. Khachatryan(1, 3-5) 1-Center of Healthcare Expertise and Quality Control, Ministry of Health of Russia, 10, Khokhlovsky Lane, Build. 5, Moscow 109028, Russian Federation; 2-Saint Petersburg State Chemopharmaceutical University, 14, Prof. Popov St., Saint Petersburg 197376, Russian Federation; 3-Institute of Applied Economic Research, 82–84, Vernadsky Prospect, Build. 9, Office 1805, Moscow 119571, Russian Federation; 4-Russian Medical Academy of Continuing Professional Education, 2/1, Barrikadnaya St., Build. 1, Moscow 125993, Russian Federation; 5-Finance Research Institute, 3, Nastasyinsky Lane, Build. 2, Moscow 127006, Russian Federation

Introduction. To determine and establish the reference value of the incremental cost-effectiveness ratio (ICER) are an urgent issue of improving the procedure for the integrated assessment of drugs when making decisions on their inclusion in the lists of drugs for medical use. In accordance with the requirements of the RF Government Decree No. 871, if the proposed drug is characterized by greater efficiency and higher cost than the comparison drug, the results of clinical and economic studies should be presented as cost-effectiveness ratios for the proposed and comparison drugs, as well as an ICER indicator. However, it is necessary to determine the standard value with which the ICER of the drug proposed to be included in these lists would be compared in the future. To analyze previously made decisions is one possible approach to determining the reference value of ICER. Objective: to calculate and analyze ICERs of antitumor drugs proposed for inclusion in the list of vital and essential drugs (VED) for 2018. Material and methods. The ICERs of antitumor drugs (ATC code L01) already included in the 2018 VED list, as well as those of antitumor drugs not approved for inclusion in this list, were analyzed. Results. The median ICER of antitumor drugs included in the 2018 VED list per QALY for the Russian Federation is 7,494,944.00 rubles. The ICER per QALY for antitumor drugs not included in the 2018 VED list varies from 2,414,634.15 to 12,164,322.73 rubles. Conclusion. The analysis revealed a significant scatter in the ICERs of drugs included in the 2018 VED list. There were also cases when the ICERs of drugs included in the VED list exceed those of drugs not approved for inclusion in this list. To more accurately determine the reference ICER for the Russian Federation, there is a need for further studies calculating the ICERs for antitumor and other drugs previously included in the VED list.

Keywords: 
incremental cost-effectiveness ratio
ICER
willingness-to-pay threshold
clinical and economic effectiveness of medicines
reference ICER
Quality-Adjusted Life Year
QALY
case-based approach

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