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.
The health plan population mix was 69% commercial, 22% Medicare, and 9% Medicaid.
Postprogression costs that have been avoided or delayed.