title: Budget impact analysis of everolimus for the treatment of hormone receptor positive, human epidermal growth factor receptor-2 negative (HER2-) advanced breast cancer in Kazakhstan.
abstract: OBJECTIVE
  The aim of this study was to determine the budget impact of everolimus (in combination with letrozole/anastrozole) as a second-line treatment for ER+ HER2- negative advanced and metastatic breast cancer in post-menopausal women.
  
  
  METHODS
  A cumulative cohort model was developed to estimate the 5-year costs associated with introducing everolimus to the Kazakh healthcare system. Two alternative market share scenarios were compared: with everolimus and without everolimus. PFS and OS data were taken from the trial and extrapolated. The background costs of the pre-progressed and post-progressed health states, drug costs and costs associated with adverse events were included in the model.
  
  
  RESULTS
  The 5-year results from the budget impact analysis demonstrate that the introduction of everolimus leads to a 12% increase in drug costs, a 2% reduction in pre-progression health state costs, a 1% increase in post-progression health state costs, and a 2% reduction in adverse event costs. The net result is only a modest increase in total costs; a 2.69% increase of T201 million, from T7.5 billion to T7.7 billion over a period of 5 years.
  
  
  CONCLUSIONS
  The analysis estimated that, if everolimus were to be introduced to the Kazakh healthcare market for the treatment of ER+ HER2- advanced breast cancer, there would be minimal impact upon overall healthcare expenditure. An increase in drug acquisitions costs was almost exactly offset by a reduction in other healthcare costs, due to improved management of the disease.
authors.affiliation: York Health Economics Consortium Ltd, University of York , York , UK.
authors.forename: Lily
authors.initials: L
authors.lastname: Lewis
authors.forename: Matthew
authors.initials: M
authors.lastname: Taylor
authors.forename: Yessentayeva
authors.initials: Y
authors.lastname: Suriya Ertugyrovna
authors.forename: Nurgaziev
authors.initials: N
authors.lastname: Kuanysh Shadybayevich
authors.forename: Smagulova
authors.initials: S
authors.lastname: Kaldygul Kabakovna
authors.forename: Abdrakhmanov
authors.initials: A
authors.lastname: Ramil Zufarovich
mesh_terms: D000077384:Anastrozole; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D000068338:Everolimus / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007623:Kazakhstan / Q000453:epidemiology; D000077289:Letrozole; D009570:Nitriles / Q000191:economics / Q000627:therapeutic use; D017698:Postmenopause; D018719:Erb-b2 Receptor Tyrosine Kinases; D014230:Triazoles / Q000191:economics / Q000627:therapeutic use
chemical_list: D000077384:Anastrozole; D000068338:Everolimus; D000077289:Letrozole; D009570:Nitriles; D018719:Erb-b2 Receptor Tyrosine Kinases; D014230:Triazoles
keywords: Breast cancer; Budget impact; Everolimus; Kazakhstan