Table 2 Methodology and BIA results

[40]

N.R

1 year

No

PO vinorelbine vs. ixabepilone

Drug cost

N.R

One-way

18,355,044 rubles for the budget fund

The use of oral vinorelbine provides financial savings for a medical organization

[37]

BIM

3 years

No

SC vs. IV trastuzumab

Drug cost, preparation and administration, indirect cost of patient productivity loss

1. Gradual Replacement: 25, 50, 75%

One-way

Total incremental costs/ 3 years: -34,527,346 SAR (USD19,181,858) in scenario 1,—69,054,692 SAR (USD36,363,717) in scenario 2

SC trastuzumab was budget saving

2. Total Replacement: 100%

[27]

Partitioned survival model

5 years

4%

Eribulin vs. non eribulin chemotherapy

Drug chemotherapy cost, weekly monitoring, radiotherapy, hospitalization, surgery

N.R

One-way and probabilistic

Annual budget impact was M€1.9 and

the annual risk of reimbursing eribulin was M€2.7

N.R

[38]

Markov

Lifetime

3.50%

Adjuvant trastuzumab vs. ST

DMC of adjuvant trastuzumab, Drugs and CT, administration, cardiac

function assessment, hospital admission, echocardiography, drugs, cardiac monitoring

N.R

One-way and two-way

1st year: 13,909 MPHP, other fiscal four years: 2946, 2509, 2110, 1910 MPHP, respectively

That markedly transcends the usual annual budget for the procurement of all BC drugs covered under the DOH BCMAP

[41]

Markov

5 years

No

Palbociclib + letrozole vs. ribociclib + letrozole

Medications, adverse event treatments

N.R

One-way

9 087 million RUB or 22.5%, saving

Using palbociclib is the cost-saving for post-menopausal women with locally advanced or metastatic HR-positive HER2-negative BC, compared to ribociclib

[28]

BIM

5 years

No

Biosimilar trastuzumab vs. originator

Drug price

25% annual market share over the 5 years

One-way

1. 20% in 1st year, switching growth of 5, 10, and 15% saved the total budget of M€1134, 1507, and 1881, respectively

3% budget saving

2. 30% in 1st year, switching growth of 5, 10, 15% saved the budget of M€1514, 1887, 2261, respectively

3. 40% in 1^st year, switching growth of 5 and 10% saved M€1894 and 2267, respectively

[34]

Cohort-based BIM

3 years

No

Ribociclib + letrozole vs. other scenarios mentioned in Table 1

Wholesale acquisition cost, administration, diarrhea,

fatigue, infection, nausea. febrile

neutropenia, pulmonary embolism, vomiting, anemia

3.3%, 11.9%, 19.3% for years 1 through 3

One-way

$3.01 M over three years

Cost-saving first-line

treatment option

[33]

Markov

Lifetime

3.50%

9 weeks vs. 52 weeks trastuzumab therapy

Drug, monitoring, recurrence and death

N.R

One-way and Bayesian probabilistic

£132 million reduction in costs

Adjuvant trastuzumab was cost-saving in England 2014

[26]

BIM

1 year

No

Biosimilar scenario 1, based on all approvals in

Drug acquisition,

N.R

One-way

1. 15% drug price discount: scenario 1: €294,940

Significant drug cost savings

2015, and biosimilar scenario 2, based on approvals after

scenario 2: €260,436

15-Feb

2. 25%: scenario 1: €491,958 scenario 2: €434,453

3. 35%: scenario 1: €688,977

scenario 2: €608,470

[39]

Cumulative cohort model

5 years

No

Everolimus + letrozole/anastrozole vs. letrozole/anastrozole, chemotherapy, tamoxifen

Hormone therapy, radiotherapy, adverse events, outpatient and inpatient services, lab test, examination, imaging, additional therapy

1% in the first year, 2% in the second year, and 3% in the third, fourth, and fifth

One-way

Incremental impact of introducing everolimus in 5 years: 201,359,752 tenge

2.69% increase in total cost, which was modest

[30]

BIM

3 years

No

TBT vs. lapatinib + capecitabine

Physician consultation, medical examination, transportation, administration, drug cost

Increases linearly over the time horizon

One-way and exploratory

€129,519,134 in 2012, €123,254,493 in 2013, €116,790,315 in 2014

The potential savings for Health Insurance with the use of oral drug due to the reduction of outpatient hospitalizations

[43]

BIM

1 year

No

Exemestane + everolimus vs. Exemestane,

Wholesale drug cost, Co-payment per fill, dispensing fee per fill

10%

One-way and two-way

Incremental budget saving: $522,336

A modest net increase in total budget

Fulvestrant, tamoxifen,

[31]

Spreadsheet model

4 years

No

Adjuvant trastuzumab vs. ST

Drug cost

N.R

One-way and probabilistic

€ 1.30

The trastuzumab acquisition costs were partially offset by the reduction in costs associated with the treatment of cancer recurrence and metastatic disease

Million

[36]

BIM

3 years

No

1. Ixabepilone monotherapy in ATC-p 2. Ixabepilone + capecitabine in AT-p patients

Drug cost

1. ATC-p: 8.39, 8.64, 8,61% for years 1 Through 3

2. AT-p: 2.09, 2.03, 2.00% for years 1 through 3

One-way and multivariate

1. ATC-p:

A relatively minimal incremental budget impact

9-week therapy was more cost-saving

$41,428,

$47,236,

$47,695 for 3 consecutive years

2. AT-p: $23,103, $22,287, $21,943 for 3 consecutive years

[32]

HEM

Lifetime

No

Adjuvant trastuzumab for 9 and 52 weeks vs. one-year non-trastuzumab therapy

Drug cost, MBC treatment cost, heart failure, administration, local recurrence, follow-up

N.R

One-way and multi-way probabilistic

5.17 M€ for 597 patients in 9 weeks trastuzumab therapy, 19.96 M€ for 491 patients in 52 weeks trastuzumab therapy

[42]

Markov

Lifetime

3%

Adjuvant trastuzumab vs. ST

Metastatic disease, local recurrence, heart failure, treatment of diseases other than BC,

N.R

One-way and multiple univariate

The additional net cost was $A7.3 million in each 1000-patient-cohort

N.R

[29]

Markov

3 years

3%

Anastrozole and letrozole vs. tamoxifen

Hormone therapy, radiotherapy, chemotherapy, antianemics, antiemetics, pain medications, doctor consultations, hospitalization, homecare assistance,

N.R

One-way

€15 million

12% budget increase