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Improving patient access to cancer drugs in India: Using economic modeling to estimate a more affordable drug cost based on measures of societal value

Published online by Cambridge University Press:  25 January 2011

George Dranitsaris ,
Ilse Truter ,
Martie S. Lubbe ,
Nitin N. Sriramanakoppa ,
Vivian M. Mendonca  and
Sangameshwar B. Mahagaonkar
George Dranitsaris
Affiliation:
Nelson Mandela Metropolitan University
Ilse Truter
Affiliation:
Nelson Mandela Metropolitan University
Martie S. Lubbe
Affiliation:
North-West University
Nitin N. Sriramanakoppa
Affiliation:
PharmARC Analytic Solutions
Vivian M. Mendonca
Affiliation:
PharmARC Analytic Solutions
Sangameshwar B. Mahagaonkar
Affiliation:
PharmARC Analytic Solutions
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Abstract

Background: Using multiples of India's per capita gross domestic product (GDP) as the threshold for economic value as suggested by the World Health Organization (WHO), decision analysis modeling was used to estimate a more affordable monthly cost in India for a hypothetical new cancer drug that provides a 3-month survival benefit to Indian patients with metastatic colorectal cancer (mCRC).

Methods: A decision model was developed to simulate progression-free and overall survival in mCRC patients receiving chemotherapy with and without the new drug. Costs for chemotherapy and side-effects management were obtained from both public and private hospitals in India. Utility estimates measured as quality-adjusted life-years (QALY) were determined by interviewing twenty-four oncology nurses using the Time Trade-Off technique. The monthly cost of the new drug was then estimated using a target threshold of US$9,300 per QALY gained, which is three times the Indian per capita GDP.

Results: The base-case analysis suggested that a price of US$98.00 per dose would be considered cost-effective from the Indian public healthcare perspective. If the drug were able to improve patient quality of life above the standard of care or survival from 3 to 6 months, the price per dose could increase to US$170 and US$253 and offer the same value.

Conclusions: The use of the WHO criteria for estimating the cost of a new drug based on economic value for a developing country like India is feasible and can be used to estimate a more affordable cost based on societal value thresholds.

Keywords

Drug pricingCost analysisChemotherapyValue
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 27 , Issue 1 , January 2011 , pp. 23 - 30
Copyright
Copyright © Cambridge University Press 2011

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