Pharmacoeconomic analysis of anemia therapy in cancer patients in real clinical practice of the Russian Federation

Purpose. To conduct a comparative clinical and economic analysis of the use of epoetin alpha (Eralfon) as a therapy of anemia in adult cancer patients with non-myeloid malignancies receiving chemotherapy in the conditions of real clinical practice in the Russian Federation. Method. In the study, a model of care for adult cancer patients with anemia receiving chemotherapy was built, the model takes into account various options for therapy with EPS. Results. The overall cost of treatment of cancer patients with anemia are less in the application of EPS short-acting — epoetin Alpha — 131 609 rubles, compared with the long-acting EPS — darbepoetin alpha 170 of 583.00 RUB, the difference amounted to RUB 38 of 974.00 (-23 %) in favour of epoetin alpha. Summary. Taking into account the data on the equivalent clinical efficacy of epoetin alpha and darbepoetin alpha, the use of the drug epoetin alpha (Eralphon) of domestic production as a therapy for anemia in adult cancer patients receiving chemotherapy in the conditions of real clinical practice in the territory of the Russian Federation is an economically more justified approach to the organization of drug care for cancer patients with anemia. 

1. Snegovoi AV, Kononenko IB, Larionova VB et al. Protokoly klinicheskikh rekomendatsii podderzhivayushchei terapii v onkologii. — M.: ABV-press, 2017:11 (In Russ).

2. Ludwig H, Van Belle S, Barrett-Lee, P, et al. The European Cancer Anaemia Survey (ECAS): a large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. European journal of cancer, 2004:40(15);2293—2306;

3. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Cancer- and Chemotherapy-Induced Anemia. Fort Washington, PA: National Comprehensive Cancer Network, 2017 Version 1.2018;

4. Federal’nyi zakon ot 05.04.2013 № 44-FZ «O kontraktnoi sisteme v sfere zakupok tovarov, rabot, uslug dlya obespecheniya gosudarstvennykh i munitsipal’nykh nuzhd» (In Russ).

5. Prikaz Ministerstva ekonomicheskogo razvitiya RF ot 25.03.2014 № 155 «Ob usloviyakh dopuska tovarov, proiskhodyashchikh iz inostrannykh gosudarstv, dlya tselei osushchestvleniya zakupok tovarov, rabot, uslug dlya obespecheniya gosudarstvennykh i munitsipal’nykh» (In Russ).

6. Postanovlenie Pravitel’stva Rossiiskoi Federatsii ot 05.02.2015 № 102 «Ob ogranicheniyakh i usloviyakh dopuska otdel’nykh vidov meditsinskikh izdelii, proiskhodyashchikh iz inostrannykh gosudarstv, dlya tselei osushchestvleniya zakupok dlya obespecheniya gosudarstvennykh i munitsipal’nykh nuzhd» (In Russ).

7. Forbes CA, Worthy G, Harker J, Kleijnen, J, Kutikova L, Zelek L, & Van Belle, S. Dose efficiency of erythropoiesis-stimulating agents for the treatment of patients with chemotherapy-induced anemia: a systematic review. Clinical therapeutics, 2014, 36(4), 594-610.

8. Crathorne L, Huxley N, Haasova M, Snowsill T, Jones-Hughes T, Hoyle M, et al. The effectiveness and cost-effectiveness of erythropoiesis-stimulating agents (epoetin and darbepoetin) for treating cancer treatment-induced anaemia (including review of technology appraisal no. 142): a systematic review and economic model. Health Technol Assess 2016;20(13).

9. Gabrilove JL, Cleeland CS, Livingston RB, et al. Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: improvements in hemoglobin and quality of life are similar to three-times-weekly dosing. Journal of Clinical Oncology, 2001, 19(11), 2875—2882.

10. Pashos CL, Larholt K, Fraser KA, et al. Outcomes of erythropoiesis-stimulating agents in cancer patients with chemotherapy-induced anemia. Supportive Care in Cancer, 2012; 20(1):159—165.

11. Steensma, DP, Dakhil SR, Novotny PJ, et al. A randomized comparison of once weekly epoetin alfa to extended schedule epoetin or darbepoetin in chemotherapy?associated anemia. American journal of hematology, 2015, 90(10), 877—881.

12. Vorob’ev PA, Avkseknt’eva MV, Borisenko OV, et al. Kliniko-ekonomicheskii analiz. Izdanie 3-e, dopolnennoe, s prilozheniyami. M.: N’’YuDIAMED; 2008: 226-229 (In Russ).

13. Postanovlenie Pravitel’stva Moskvy ot 24 February 2010 №163-PP «Ob ustanovlenii torgovykh nadbavok k tsenam na lekarstvennye sredstva, vklyuchennye v perechen’ ZhNVLP» (In Russ).

14. Ofitsial’naya instruktsiya po primeneniyu lekarstvennogo preparata Aranesp®. Gosudarstvennyi reestr lekarstvennykh sredstv (In Russ). Доступно по: http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=00daf100-b00d-408c-a537-1ee3001ef467&t= Ссылка активна на: 24.10.2017 г.

15. Ofitsial’naya instruktsiya po primeneniyu lekarstvennogo preparata Eral’fon®. Gosudarstvennyi reestr lekarstvennykh sredstv (In Russ). Доступно по: http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=5d1f22a1-e2cf-47f3-908e-5c8e9ee4aa12&t= Ссылка активна на: 24.10.2017 г.

16. Tarifnoe soglashenie na oplatu meditsinskoi pomoshchi, okazyvaemoi po territorial’noi programme obyazatel’nogo meditsinskogo strakhovaniya goroda Moskvy na 2017 29.12.2016, Moskovskii gorodskoi fond obyazatel’nogo meditsinskogo strakhovaniya (In Russ).

17. Prilozhenie № 6 k Tarifnomu soglasheniyu na oplatu meditsinskoi pomoshchi, okazyvaemoi po territorial’noi programme obyazatel’nogo meditsinskogo strakhovaniya goroda Moskvy na 2017 29.12.2016, Moskovskii gorodskoi fond obyazatel’nogo meditsinskogo strakhovaniya (In Russ).

18. Prilozhenie № 8.1 k Tarifnomu soglasheniyu na oplatu meditsinskoi pomoshchi, okazyvaemoi po territorial’noi programme obyazatel’nogo meditsinskogo strakhovaniya goroda Moskvy na 2017 29.12.2016, Moskovskii gorodskoi fond obyazatel’nogo meditsinskogo strakhovaniya (In Russ).

19. Kaprin A.D., Starinskii V.V., Petrova G.V. Zlokachestvennye novoobrazovaniya v Rossii v 2015 godu (zabolevaemost’ i smertnost’). M.: MNIOI im. P.A. Gertsena — filial FGBU «NMIRTs» Minzdrava Rossii — 2017: 250 (In Russ).