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The Budget Impact of Including Rucaparib on a US Payer Formulary for the Treatment of Patients with Metastatic Ovarian Cancer

Abstract

Objective

A budget impact model was constructed to assess the incremental budget impact that rucaparib availability would have on a US health plan.

Methods

An incremental budget impact was estimated over a 3-year horizon as the difference in total annual cost of treatment, with and without rucaparib available, for second-line maintenance, third-line treatment, and the combined maintenance and treatment settings. The hypothetical health plan includes one million covered lives, and commercial and Medicare lines of business. Alternative products included in the model were based on the National Comprehensive Cancer Network guidelines. The eligible patient population was estimated using an incidence-based approach. Modeled costs include drug acquisition, intravenous drug administration, required laboratory testing, and medical management of adverse events.

Results

In the maintenance setting, average total expenditures over 3 years were estimated to be US$1,465,043 with rucaparib versus US$1,461,350 without it as a treatment option; the average incremental budget impact was US$3693 (US$0.0003 per member per month [PMPM]). In the treatment setting, average total expenditures were estimated to be US$1,320,718 with rucaparib versus US$1,313,736 without it; the average incremental budget impact was US$6982 (US$0.0006 PMPM). Budget impact is smaller in commercial plans than Medicare because of the higher incidence of ovarian cancer in the over-65 population.

Conclusion

The budget impact of adding rucaparib to the formulary for a health plan adds negligible PMPM costs of < US$0.001 in all tested settings and scenarios due to the small population eligible for therapy.

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Acknowledgements

Editorial assistance funded by Clovis Oncology, Inc., was provided by Shelly Lim and Frederique H. Evans of Ashfield Healthcare Communications.

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Authors and Affiliations

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Corresponding author

Correspondence to Katrine Wallace.

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Funding

This study was funded by Clovis Oncology, Inc., and was designed and conducted by the funder.

Conflict of interest

Katrine Wallace and Ashwini Pai are employees of Clovis Oncology, Inc., and may own stock or have stock options in that company. Kelly Adamski and Anita Chawla are employees of Analysis Group, which received consulting fees from Clovis Oncology. Darya Rose is a previous employee of Analysis Group.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

Author Contributions

KW directed the project, provided all cost and epidemiology inputs for the model, and wrote the manuscript. KA, DR, and AC developed the methodology and programming and constructed the model. AP provided all clinical data inputs for the model. All authors reviewed and contributed to revisions of the manuscript.

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Wallace, K., Adamski, K., Pai, A. et al. The Budget Impact of Including Rucaparib on a US Payer Formulary for the Treatment of Patients with Metastatic Ovarian Cancer. PharmacoEconomics 39, 231–241 (2021). https://doi.org/10.1007/s40273-020-00970-y

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  • DOI: https://doi.org/10.1007/s40273-020-00970-y