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Original ArticleOpen Access
Budget Impact Analysis of Pemetrexed Introduction: Case Study from a Teaching Hospital Perspective, Thailand
Chanjaruporn F 
,
Roughead EE ,
Sooksriwong C ,
Kaojarern S
,
Roughead EE ,
Sooksriwong C ,
Kaojarern S Objective: Thailand does not currently require Budget Impact Analysis (BIA) assessment. The present study aimed to estimatethe annual drug cost and the incremental impact on the hospital pharmaceutical budget of the introduction of pemetrexed toa Thai teaching hospital.
Material and Method: The budget impact model was conducted in accordance with the Guidelines for preparing submissionsto the Pharmaceutical Benefits Advisory Committee (PBAC). The model variables consisted of number of patients, growthrate of lung cancer, uptake rate of pemetrexed over time, unit prices of drugs, and the length and cost of treatment. Sensitivityanalysis was performed to determine changes in budgetary impact due to variation of parameters or assumptions in themodel.
Results: The introduction of pemetrexed was estimated to cause considerable costs for the teaching hospital. In the base-caseanalysis, the incremental costs were estimated at 8,553,984 Baht in the first year increasing to 12,118,144 Baht, 17,820,800Baht and 17,820,800 Baht in the following years. The 4-year net budgetary impact was 20,154,480 Baht or approximately127,560 Baht per patient. Sensitivity analyses found that number of treatment cycles and proportion of patients assumed to betreated with pemetrexed were the two most important influencing factors in the model.
Conclusion: New costly innovative interventions should be evaluated using the BIA model to determine whether they areaffordable. The Thai government should consider requiring the BIA study as one of the requirements for drug submission toassist in the determination of listing and subsidizing decision for medicines.
Keywords: Budget impact analysis, Pemetrexed, Teaching hospital, Pharmaceutical subsidization
Material and Method: The budget impact model was conducted in accordance with the Guidelines for preparing submissionsto the Pharmaceutical Benefits Advisory Committee (PBAC). The model variables consisted of number of patients, growthrate of lung cancer, uptake rate of pemetrexed over time, unit prices of drugs, and the length and cost of treatment. Sensitivityanalysis was performed to determine changes in budgetary impact due to variation of parameters or assumptions in themodel.
Results: The introduction of pemetrexed was estimated to cause considerable costs for the teaching hospital. In the base-caseanalysis, the incremental costs were estimated at 8,553,984 Baht in the first year increasing to 12,118,144 Baht, 17,820,800Baht and 17,820,800 Baht in the following years. The 4-year net budgetary impact was 20,154,480 Baht or approximately127,560 Baht per patient. Sensitivity analyses found that number of treatment cycles and proportion of patients assumed to betreated with pemetrexed were the two most important influencing factors in the model.
Conclusion: New costly innovative interventions should be evaluated using the BIA model to determine whether they areaffordable. The Thai government should consider requiring the BIA study as one of the requirements for drug submission toassist in the determination of listing and subsidizing decision for medicines.
Keywords: Budget impact analysis, Pemetrexed, Teaching hospital, Pharmaceutical subsidization
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