title: Budget impact analysis of pemetrexed introduction: case study from a teaching hospital perspective, Thailand.
abstract: OBJECTIVE
  Thailand does not currently require Budget Impact Analysis (BIA) assessment. The present study aimed to estimate the annual drug cost and the incremental impact on the hospital pharmaceutical budget of the introduction of pemetrexed to a Thai teaching hospital.
  
  
  METHODS
  The budget impact model was conducted in accordance with the Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee (PBAC). The model variables consisted of number of patients, growth rate of lung cancer, uptake rate of pemetrexed over time, unit prices of drugs, and the length and cost of treatment. Sensitivity analysis was performed to determine changes in budgetary impact due to variation of parameters or assumptions in the model.
  
  
  RESULTS
  The introduction of pemetrexed was estimated to cause considerable costs for the teaching hospital. In the base-case analysis, the incremental costs were estimated at 8,553,984 Baht in the first year increasing to 12, 118, 144 Baht, 17,820,800 Baht and 17,820,800 Baht in the following years. The 4-year net budgetary impact was 20,154,480 Baht or approximately 127,560 Baht per patient. Sensitivity analyses found that number of treatment cycles andproportion of patients assumed to be treated with pemetrexed were the two most important influencing factors in the model.
  
  
  CONCLUSIONS
  New costly innovative interventions should be evaluated using the BIA model to determine whether they are affordable. The Thai government should consider requiring the BIA study as one of the requirements for drug submission to assist in the determination of listing and subsidizing decision for medicines.
authors.affiliation: Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Thailand.
authors.forename: Farsai
authors.initials: F
authors.lastname: Chanjaruporn
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Roughead
authors.forename: Cha-oncin
authors.initials: CO
authors.lastname: Sooksriwong
authors.forename: Sming
authors.initials: S
authors.lastname: Kaojarern
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D002017:Budgets / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis / Q000379:methods; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D005971:Glutamates / Q000191:economics* / Q000627:therapeutic use; D006147:Guanine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs; D006784:Hospitals, Teaching; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D008875:Middle Aged; D018803:Models, Economic; D000068437:Pemetrexed; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013785:Thailand
chemical_list: D000970:Antineoplastic Agents; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine