OBJECTIVES: To examine the economic implications and annual budget impact of everolimus as a treatment for metastatic renal cell carcinoma (mRCC) based upon current therapy options from a US payer perspective.
STUDY DESIGN: An Excel-based cross-sectional budget impact model.
METHODS: Two market scenarios, one where everolimus was not a treatment option (April 2008 to March 2009) and one where everolimus was a treatment option (October 2009 to September 2010), were compared. Along with everolimus, systemic chemotherapeutic agents and targeted therapies were considered for the model. Costs included to estimate the budgetary impact were related to drug acquisition, drug administration (ie, intravenous infusions), and adverse event management (2010 US dollars). Market share data for all treatments were obtained from real-time drug utilization data from 36 states across the United States. Aggregate annual budget impacts per member per month (PMPM) and per member per year (PMPY) were evaluated.
RESULTS: In a hypothetical population of 1 million with an mRCC prevalence of 0.0203% where 90% of patients receive treatment, the aggregated budget in the pre-everolimus launch market was found to be $7,050,157; for the post-everolimus launch market it was $6,741,642. This resulted in savings of $308,516 in the post-everolimus market; PMPM and PMPY savings across all plan members were $0.03 and $0.31, respectively.
CONCLUSIONS: Introducing everolimus as second-line or third-line therapy to vascular endothelial growth factor tyrosine-kinase inhibitors resulted in minimal budget impact. Trends remained consistent across scenario analyses in which everolimus replaced different combinations of comparators.
