The substantiation of the cost optimization for ER(+) HER2(−) breast cancer hormone therapy based on the results of the cost minimization pharmacoeconomic analysis

Aim. To determine the most cost-effective drugs among aromatase inhibitors and antiestrogens used in hormone therapy regimens for the ER(+) HER2(−) breast cancer according to the results of the pharmacoeconomic analysis. Materials and methods. The pharmacoeconomic analysis by the cost minimization method of hormone therapy regimens for patients with the ER(+) HER2(−) breast cancer using aromatase inhibitors and antiestrogens was performed. Results. In order to determine the least expensive drugs among aromatase inhibitors and antiestrogens used for the treatment of the hormone-dependent breast cancer, a limited cost minimization analysis was conducted for 6 trade names (TNs) of anastrozole, 12 TNs of letrozole, 5 TNs of exemestane and among antiestrogens by international non-patent name (INN): tamoxifen, toremifene and fulvestrant, each of which is represented by 3 TNs. The indicator of a one-year course of treatment with drugs at average wholesale prices was calculated. The following drugs were determined as the ones with the least cost of a one-year course of treatment for the hormone-dependent breast cancer: among TNs of toremifene – Fareston tab., 60 mg, No. 60 (10493.49 UAH); among TNs of tamoxifen – Tamoxifen-Zdorovya tab., 10 mg, No. 60 (2071.56 UAH); among TNs of fulvestrant – Fulveject sol. for inj., 250 mg / 5 ml sirynge, No. 2 (81227.78 UAH); among TNs of letrozole – Letrozole-Vista AS film-coated tab., 2.5 mg (5907.19 UAH); among TNs of anastrozole – Anastrozole-Vista film-coated tab., 1 mg (7737.36 UAH); among TNs of exemestane – Exemarin sugar-coated tab., 25 mg (6 838.36 UAH). Conclusions. Based on the results of the limited cost minimization pharmacoeconomic analysis conducted, the expediency of using drugs with the lowest cost for a one-year course of the hormone-dependent breast cancer treatment has been substantiated, provided that they are equally effective among aromatase inhibitors and antiestrogens. The inclusion of selected drugs in the list of public procurement provides an opportunity to optimize the costs for treating the hormone-dependent ER(+) HER2(−) breast cancer and optimally spend financial resources on healthcare.