Build a Budget Impact Analysis Model
Angelia19872020
sample.pptxYou are an employee at Novartis. The company is currently addressing potential exclusions from formulary due to the introductions of generic versions as well as the introduction of other branded competitors. The company would like to develop a budget impact analysis and understand the budget impact in the treatment of Newly diagnosed adult with Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase for both the Commercial and Medicare populations. You are tasked with developing this analysis as an economic model and providing your senior management with the budget impact and per member per month (PMPM) impact for both payer types.
Additional key question to answer: What is the discount needed to stay cost neutral with generic versions as well other branded products that fall within the same therapeutic class (tyrosine kinase inhibitors) of the market uptake that must occur such that the budget impact to payers exceeds $0.05 PMPM at 3 years?
DMS：Dasatinib
Dosing: One pill, once daily, either in the morning or in the evening
Dosing is the same for both newly diagnosed and imatinib-resistant or -intolerant CP Ph+ CML patients. For patients taking Dasatinib 100 mg daily, a dose decrease to 20 mg should be considered.
Novartis: : Tasigna® (nilotinib)
Dosing：300 mg
TASIGNA® (nilotinib) capsules doses should be taken approximately 12 hours apart. Adult patients should take 2 capsules in the morning and 2 capsules in the evening Capsules should be swallowed whole with water Patients must avoid food for 2 hours before and 1 hour after each dose For patients who cannot swallow TASIGNA capsules whole, the contents of each capsule may be sprinkled in 1 teaspoon of applesauce (puréed apple). The mixture should be swallowed right away (within 15 minutes) and should not be stored for future use
indicated population
Comparators--Dasatinib
| Model feature | Description | Notes |
| Perspective and audience | payers | Novartis |
| Population | Commercial and Medicare | |
| Indication | The worldwide annual incidence of CML is approximately 1–1.5 in 100,000 persons.In United State, 8990 people were diagnosed with CML in 2019. | |
| Time horizon | 5 years | |
| Cost | $16470/50mg | The cost for Tasigna oral capsule 50 mg is around $16,470 for a supply of 120 capsules, depending on the pharmacy you visit |
| Drug | brand/generic | Dose frequency | strength | Doses per administration/year | Average Wholesale Price (AWP) |
| Nilotinib(Tasigna) | brand | Daily | 400mg | 2/365 | $196,473 |
| Dasatinib(Sprycel) | brand | Daily | 100mg | 1/365 | $185,932 |
| Imatinib(Gleevec) | brand | Daily | 400mg | 2/365 | $145,764 |
| Bosutinib(Bosulif) | brand | Daily | 500mg | 1/365 | $204,706 |
| Ponatinib(Iclusig) | brand | Daily | 45mg | 1/365 | $238,478 |
Comparators
| Feature | Product of Novartis | Product of DMS |
| Benefit design | Medical | Medical |
| Patient cost-sharing | Co-insurance(initial coverage phase:25% to 33%-coverage gap phase: 45%-50% coinsurance) | Co-pay (driven from 4171 to 16684) |
| Mode of administration | Orally twice daily | Oral once daily |
| Duration of treatment | Chronic(18.4 months) | Chronic(15 months) |
| Site of care | Hospital outpatient | Hospital outpatient |
| Lab testing | No monitoring | No monitoring |
| Side effect | an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. | Diarrhea, nausea/vomiting,headache, muscle pain, pain in your hands or feet |
Population
Treatment Mix
Commercial Drug Costs
Medicare Drug Costs
Commercial Budget Impact
Drug Costs(Commercial)
Medicare Budget Impact
Drug Costs(Medicare)
