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This section of First Report Managed Care focuses on reporting the latest in health care economics and outcomes research for a variety of treatments and disease states.

Researchers recently presented the potential cost-saving benefits of switching breast cancer patients from olaparib to talazoparib in an AMCP eLearning Days poster session.

“Talazoparib may represent a cost-saving treatment option vs olaparib for patients with [germline breast cancer susceptibility gene 1 or 2-mutated (gBRCA1/2mut) human epidermal growth factor receptor 2-negative (HER2−) locally advanced or metastatic breast cancer] from a US payer perspective,” explained Bhakti Arondekar, PhD, vice president, HEOR and Market Access, Oncology (Prostate and Biosimilars), Pfizer, and colleagues found.

In a previous phase 3 EMBRACA trial, (NCT01945775), “Talazoparib, a poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor, demonstrated significant benefit in median progression-free survival (PFS) over standard chemotherapy (hazard ratio 0.54; 95% confidence interval, 0.41-0.71; < 0.001; median 8.6 vs 5.6 months).”

Dr Arondekar and colleagues expanded upon the EMBRACA trial and sought to estimate the incremental budget impact of including talazoparib on a health plan formulary for the treatment of adult patients with gBRCA1/2mut HER2− advanced breast cancer.

“The model estimated the incremental cost of introducing talazoparib to a health plan formulary over a 3-year time horizon for its FDA-approved indication,” explained the researchers. Further, “the model compared two scenarios; treatments with current real-world standard of care with and without talazoparib.”

For the purpose of the study, treatment utilization rates for the non-PARP inhibitors basket of treatments were derived based on real-world data and it was assumed that the PARP inhibitor olaparib had a 20% utilization rate. In the second scenario, which included talazoparib, it was assumed that a proportion of patients will start on talazoparib in lieu of olaparib.

“After adding talazoparib to a US commercial health plan with one million members, half of the patients started talazoparib in lieu of olaparib resulting in a decrease of treatment costs by $35,658 and an increase in adverse event management costs by $5,239,” found the researchers. “This corresponds to potential incremental cost-savings of $242 per treated member per month.”

While the study shows promising results Dr Arondekar and colleagues concluded that future studies will be necessary to further to validate the results using real-world US health plans’ data.

—Edan Stanley


Arondekar B, Biskupiak J, Brixner D, et al. Budget Impact Model of Including Talazoparib on US Payer Formulary for the Treatment of Adult Patients With Germline BRCA1/2-mutated, HER2− Locally Advanced or Metastatic Breast Cancer. Poster presented at the AMCP eLearning Days, April 20–24, 2020.

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