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. 2020 Nov 17;3(11):e2025866. doi: 10.1001/jamanetworkopen.2020.25866

Table 2. Budget Impact Model Results for Avapritinib for a 1-Million Member Health Plan by Cost Typea.

Model Value
Year 1 Year 2 Year 3
GIST, PDGFRA exon 18, and fourth-line treatment
Eligible patients, No. 1.22 1.24 1.26
Total cost, $
With avapritinib available 96 157 133 403 177 809
Without avapritinib available 51 120 56 646 62 205
Incremental budget impact
Total, $ 45 038 76 758 115 604
Owing to change in postprogression costs, $b −454 −1999 −3607
PMPM 0.004 0.006 0.010
GIST and PDGFRA exon 18
Eligible patients, No. 0.07 0.08 0.09
Total cost, $
With avapritinib available 19 200 41 398 65 636
Without avapritinib available 8192 13 461 18 761
Incremental budget impact
Total, $ 11 007 27 937 46 875
Owing to change in postprogression costs, $b −610 −2224 −3924
PMPM 0.001 0.002 0.004
GIST and fourth-line treatment
Eligible patients, No. 1.15 1.16 1.17
Total cost, $
With avapritinib available 78 203 93 408 113 735
Without avapritinib available 44 024 44 288 44 553
Incremental budget impact
Total, $ 34 179 49 121 69 182
Owing to change in postprogression costs, $b 157 225 317
PMPM 0.003 0.004 0.006

Abbreviations: GIST, gastrointestinal stromal tumors; PDGFRA, platelet-derived growth factor receptor alpha; PMPM, per member per month.

a

The health plan population mix was 69% commercial, 22% Medicare, and 9% Medicaid.

b

Postprogression costs that have been avoided or delayed.