Análisis del impacto presupuestario tras la comercialización de nilotinib en el tratamiento de primera línea en pacientes con leucemia mieloide ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-03

AUTHORS

Emmanuel Giménez García, M. Angeles Portero, Concepción Boqué, Asunción Echeveste, Raquel de Paz, Santiago del Castillo, Reyes Calzada, Juan Diego González, Valentín García-Gutiérrez

ABSTRACT

Los inhibidores de tirosina quinasa de segunda generación, nilotinib y dasatinib, obtuvieron recientemente la indicación para tratar a pacientes con leucemia mieloide crónica de nuevo diagnóstico en primera línea, presentando mejores perfiles de eficacia y seguridad que imatinib. El objetivo es estimar el impacto presupuestario del primer año de tratamiento de los pacientes incidentes en 2012, 2013 y 2014 considerando aumentos progresivos de pacientes tratados con nilotinib en España. Modelo farmacoeconómico de costes directos bajo la perspectiva del Sistema Nacional de Salud. Los datos epidemiológicos provienen de la literatura científica, los ensayos ENESTnd y DASISION, y del manejo clínico de un panel de expertos en la patología. Adicionalmente se realizó un análisis de sensibilidad. Contrastar un mercado constante mayoritario de imatinib (80 %) y del 10 % en las alternativas, con otro con aumentos acumulativos de nilotinib del 10 % (por un 70 % de imatinib; 30 % de dasatinib) implica un ahorro prácticamente equivalente a un impacto presupuestario nulo con los beneficios clínicos de aumentar el porcentaje de pacientes con un fármaco de segunda generación. El coste farmacológico sube, pero se ahorra en las otras partidas: menos monitorizaciones (mejor respuesta citogenética y molecular), trasplantes (menor tasa de fallo y progresión) y menos efectos adversos y hospitalizaciones. El modelo fue sensible al número de pacientes por tratamiento, aun observándose ahorros en todos los escenarios en las partidas no farmacológicas, y alcanzando un escenario de aumento máximo del gasto total del 8 %. Nilotinib usado en primera línea de tratamiento tiene un impacto clínico y económico que invita a considerarlo como la mejor opción terapéutica. More... »

PAGES

5-14

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s40277-013-0004-9

DOI

http://dx.doi.org/10.1007/s40277-013-0004-9

DIMENSIONS

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