IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v22y2021i6d10.1007_s10198-021-01303-2.html
   My bibliography  Save this article

Economic evaluation of orphan drug Lutetium-Octreotate vs. Octreotide long-acting release for patients with an advanced midgut neuroendocrine tumour in the Netherlands

Author

Listed:
  • Marije E. Hagendijk

    (University of Groningen
    Coronel Institute of Occupational Health and Research Center for Insurance Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute)

  • Simon Schans

    (University of Groningen, University Medical Center Groningen
    Fair Medicine Foundation)

  • Cornelis Boersma

    (University of Groningen, University Medical Center Groningen
    Open University)

  • Maarten J. Postma

    (University of Groningen
    University of Groningen, University Medical Center Groningen
    Institute of Science in Healthy Aging and Healthcare (SHARE), University of Groningen, University Medical Center Groningen)

  • Simon Pol

    (University of Groningen, University Medical Center Groningen)

Abstract

Objectives Multiple studies showed positive effects of Lutetium-Octreotate (LO) treatment in neuroendocrine tumours. LO has been used in the Netherlands since the 1980s and recently received the orphan status shortly after the acquisition by Novartis. Since then, the official list price has increased sixfold. From a value-based pricing perspective, we analysed the impact of the increase in price on the incremental cost-effectiveness ratio (ICER) of LO treatment compared to optimal best supportive care, a high dose of Octreotide long-acting release (O-LAR), using the clinical data of the NETTER-1 trial. Methods A Markov model was developed to evaluate the costs per quality-adjusted life-year (QALY) for LO treatment compared to O-LAR from the healthcare perspective. A scenario analysis was conducted to compare the cost-effectiveness with the initial and increased price level of the LO-treatment. Results At the increased price level, the cost-effectiveness analysis rendered a deterministic ICER of €53,500 per QALY, while at the initial pricing, the ICER was €19,000 per QALY. The probabilistic sensitivity analysis (PSA) showed that LO had a high probability of being cost-effective at both the increased and initial price level, considering a cost-effectiveness threshold of €80,000. Conclusions Even at the increased price level, LO treatment can still be considered cost-effective using the applicable Dutch willingness-to-pay threshold of 80,000 euro per QALY. Considering the public scrutiny in relation to this price increase, these outcomes raise the question whether traditional cost-effectiveness methods are sufficient in fully capturing the societal acceptance of prices of new medicines.

Suggested Citation

  • Marije E. Hagendijk & Simon Schans & Cornelis Boersma & Maarten J. Postma & Simon Pol, 2021. "Economic evaluation of orphan drug Lutetium-Octreotate vs. Octreotide long-acting release for patients with an advanced midgut neuroendocrine tumour in the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(6), pages 991-999, August.
    • Handle: RePEc:spr:eujhec:v:22:y:2021:i:6:d:10.1007_s10198-021-01303-2
    DOI: 10.1007/s10198-021-01303-2
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-021-01303-2
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10198-021-01303-2?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Linda Ryen & Mikael Svensson, 2015. "The Willingness to Pay for a Quality Adjusted Life Year: A Review of the Empirical Literature," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1289-1301, October.
    2. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2001. "Representing uncertainty: the role of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 779-787, December.
    3. J. Jaime Caro & Erik Nord & Uwe Siebert & Alistair McGuire & Maurice McGregor & David Henry & Gérard de Pouvourville & Vincenzo Atella & Peter Kolominsky‐Rabas, 2010. "The efficiency frontier approach to economic evaluation of health‐care interventions," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1117-1127, October.
    4. Jackson, Christopher, 2016. "flexsurv: A Platform for Parametric Survival Modeling in R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 70(i08).
    5. P. Pedram Sendi & Andrew H. Briggs, 2001. "Affordability and cost‐effectiveness: decision‐making on the cost‐effectiveness plane," Health Economics, John Wiley & Sons, Ltd., vol. 10(7), pages 675-680, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Raymond C. W. Hutubessy & Louis W. Niessen & Rob F. Dijkstra & Ton F. Casparie & Frans F. Rutten, 2005. "Stochastic league tables: an application to diabetes interventions in the Netherlands," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 445-455, May.
    2. Fischer, Barbara & Telser, Harry & Zweifel, Peter & von Wyl, Viktor & Beck, Konstantin & Weber, Andreas, 2023. "The value of a QALY towards the end of life and its determinants: Experimental evidence," Social Science & Medicine, Elsevier, vol. 326(C).
    3. Maarten Ijzerman & Lotte Steuten, 2011. "Early assessment of medical technologies to inform product development and market access," Applied Health Economics and Health Policy, Springer, vol. 9(5), pages 331-347, September.
    4. Werner B. F. Brouwer & Frans F. H. Rutten, 2010. "The efficiency frontier approach to economic evaluation: will it help German policy making?," Health Economics, John Wiley & Sons, Ltd., vol. 19(10), pages 1128-1131, October.
    5. Elizabeth G Bond & Lusine Abrahamyan & Mohammad K A Khan & Andrea Gershon & Murray Krahn & Ping Li & Rajibul Mian & Nicholas Mitsakakis & Mohsen Sadatsafavi & Teresa To & Petros Pechlivanoglou & for t, 2020. "Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-16, August.
    6. Karl Claxton & Elisabeth Fenwick & Mark J. Sculpher, 2012. "Decision-making with Uncertainty: The Value of Information," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 51, Edward Elgar Publishing.
    7. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Nonpharmacological Interventions for Dementia Patients and their Caregivers - A Systematic Literature Review," Working Papers 2018:10, Lund University, Department of Economics.
    8. Neil Hawkins & Mark Sculpher & David Epstein, 2005. "Cost-Effectiveness Analysis of Treatments for Chronic Disease: Using R to Incorporate Time Dependency of Treatment Response," Medical Decision Making, , vol. 25(5), pages 511-519, September.
    9. McNamara, Simon & Tsuchiya, Aki & Holmes, John, 2021. "Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment," Social Science & Medicine, Elsevier, vol. 269(C).
    10. Andrea Manca & Neil Hawkins & Mark J. Sculpher, 2005. "Estimating mean QALYs in trial‐based cost‐effectiveness analysis: the importance of controlling for baseline utility," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 487-496, May.
    11. Sylvain Druais & Agathe Doutriaux & Magali Cognet & Annabelle Godet & Christophe Lançon & Pierre Levy & Ludovic Samalin & Pascal Guillon, 2016. "Cost Effectiveness of Paliperidone Long-Acting Injectable Versus Other Antipsychotics for the Maintenance Treatment of Schizophrenia in France," PharmacoEconomics, Springer, vol. 34(4), pages 363-391, April.
    12. A. Gafni & S. D. Walter & S. Birch & P. Sendi, 2008. "An opportunity cost approach to sample size calculation in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 17(1), pages 99-107, January.
    13. Tzeyu L. Michaud & Robert L. Kane & J. Riley McCarten & Joseph E. Gaugler & John A. Nyman & Karen M. Kuntz, 2018. "Using Cerebrospinal Fluid Biomarker Testing to Target Treatment to Patients with Mild Cognitive Impairment: A Cost-Effectiveness Analysis," PharmacoEconomics - Open, Springer, vol. 2(3), pages 309-323, September.
    14. José Leal & Stefania Manetti & James Buchanan, 2018. "The Impact of Hospital Costing Methods on Cost-Effectiveness Analysis: A Case Study," PharmacoEconomics, Springer, vol. 36(10), pages 1263-1272, October.
    15. Alejandro Arrieta & Timothy F Page & Emir Veledar & Khurram Nasir, 2017. "Economic Evaluation of PCSK9 Inhibitors in Reducing Cardiovascular Risk from Health System and Private Payer Perspectives," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-14, January.
    16. Klingler, Corinna & Shah, Sara M.B. & Barron, Anthony J.G. & Wright, John S.F., 2013. "Regulatory space and the contextual mediation of common functional pressures: Analyzing the factors that led to the German Efficiency Frontier approach," Health Policy, Elsevier, vol. 109(3), pages 270-280.
    17. McKenna, Claire & Chalabi, Zaid & Epstein, David & Claxton, Karl, 2010. "Budgetary policies and available actions: A generalisation of decision rules for allocation and research decisions," Journal of Health Economics, Elsevier, vol. 29(1), pages 170-181, January.
    18. J. Brown & N. J. Welton & C. Bankhead & S. H. Richards & L. Roberts & C. Tydeman & T. J. Peters, 2006. "A Bayesian approach to analysing the cost‐effectiveness of two primary care interventions aimed at improving attendance for breast screening," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 435-445, May.
    19. Sharples, Linda D., 2018. "The role of statistics in the era of big data: Electronic health records for healthcare research," Statistics & Probability Letters, Elsevier, vol. 136(C), pages 105-110.
    20. Rachel Elliott & Koen Putman & Matthew Franklin & Lieven Annemans & Nick Verhaeghe & Martin Eden & Jasdeep Hayre & Sarah Rodgers & Aziz Sheikh & Anthony Avery, 2014. "Cost Effectiveness of a Pharmacist-Led Information Technology Intervention for Reducing Rates of Clinically Important Errors in Medicines Management in General Practices (PINCER)," PharmacoEconomics, Springer, vol. 32(6), pages 573-590, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:22:y:2021:i:6:d:10.1007_s10198-021-01303-2. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.