Качественная клиническая практика (May 2018)
Impact on the budget of ONLS program of vedolizumab introduction for the treatment of inflammatory bowel disease
Abstract
Aim. Evaluation of the impact on the budget of the program for the provision of necessary medications (ONLS program) for the inclusion of a new drug vedolizumab for the treatment of adult patients with moderate or severe active ulcerative colitis (UC) and moderate or severe active Crohn’s disease (CD). Material and methods. The analysis provides a retrospective study based on published data. Based on the results of the auctions for the purchase of compared drugs, the size of the target population of the patients was calculated in the framework of ONLS. The calculation was carried out taking into account the proportion of drugs used for the therapy of inflammatory bowel diseases (IBD) in the total volume of purchased inhibitors of TNF-a. For the target group identified, the budget load is determined with the gradual replacement of TNFa inhibitors with vedolizumab. The horizon of the study was 3 years. The calculations used the average tender prices for the package of the preparation for 2016. Results. It is established that the cost of 1 year of therapy with vedolizumab is lower than that for infliximab, adalimumab or golimumab. The inclusion of vedolizumab in ONLS implies the subsequent replacement of TNFa inhibitors by vedolizumab: in the first year in 11% of patients with UC and 15% of patients with CD, in the second year in 17 and 32%, respectively, in the 3rd year 28 and 43% respectively. This allows to reduce the budget impact for 3 years for the treatment of UC by 11,9 million rubles, and for CD therapy by 24,1 million rubles. With the increase in the share of vedolizumab on the market by replacing TNFa inhibitors, budgetary savings are increasing. Vedolizumab therapy is the most effective option in the treatment of IBD from a clinical and clinico-economic point of view in comparison with TNFa inhibitors. Conclusion. The inclusion of the drug vedolizumab in ONLS is pharmacoeconomically feasible. The use of vedolizumab in terms of Budget impact Analysis is preferable to the current treatment regimen including infliximab, adalimumab, golimumab and cerolizumab pegol.
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