Budget Impact Analysis of Tirbanibulin Field Therapy for Actinic Keratosis in Adult Patients

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Publication Date

11-7-2023

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Presentation: 25:37

Abstract

Actinic keratosis (AK) is a condition of precancerous lesions that if left untreated, can progress to invasive squamous-cell carcinoma (SCC). Progression rates from AK to SCC range from 0.025%-16% and regression from 15%-63%. Due to the unpredictability, it is recommended that all lesions are treated. Prevalence in the US was 58 million persons in 2021, equating to 17% of the population. AKs are more commonly seen in older men with lighter skin who have a history of prolonged sun exposure, as well as those who are immunocompromised. There are numerous treatment options with varying profiles including 5-fluorouracil, diclofenac, imiquimod, BF-200 aminolevulinic acid (ALA), and tirbanibulin, the newest approved medication for AK. The purpose of this study was to build a budget impact analysis to explore the cost implications of including tirbanibulin on a healthcare formulary from a U.S. payer perspective. A hypothetical one-million-member plan was used to calculate per member per year (PMPY) and per member per month (PMPM) cost over a one-year horizon using estimated market shares. The analysis indicated that the PMPM cost for tirbanibulin ranged from $0.19-$0.57 if market shares were between 5-15%. This cost was comparable to the other FDA approved field therapies, and lower than diclofenac, imiquimod 5% and 5-flourouracil 0.5%. According to these results, the introduction of this medication in a formulary from a U.S. payer perspective appears to be cost-effective. Addition of other parameters such as adherence, recurrence rates, local skin reactions, precise market share, and cost associated with quality of life (QoL) would further increase the robustness of this analysis to establish the most cost-effective field therapies for actinic keratosis.

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English

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