DOI: 10.5061/dryad.pc866t1wn
title: Data from: Cost-minimization analysis Phesgo model

description: The main objective of this study is to determine whether the employment of
 fixed-dose combination of pertuzumab and trastuzumab for subcutaneous
 injection (or Phesgo) to treat metastatic HER2-positive breast cancer
 patients would minimize costs compared to the traditional treatment of
 separate intravenous doses of pertuzumab and trastuzumab in Peru. To
 achieve this, we used EsSalud (the social security health insurance) data
 and assessed it through a mixed strategy, which consisted of a
 quantitative and a qualitative approach. The first one aimed to calculate
 the direct (non-drug consumables, drugs, and healthcare professionals) and
 indirect costs of both treatments to develop a comparison, whilst the
 second aimed to validate information and internalize the procedure in an
 EsSalud context. Overall, we found that the usage of Phesgo would be cost
 saving in EsSalud’s context. Specifically, we found three main insights.
 Firstly, the savings produced from switching from the traditional
 intravenous treatment to the subcutaneous one would allow EsSalud to
 afford full annual costs of 2 additional treatments, but without
 increasing their budget. This would cover 7% of the gap of 29 patients who
 do not have access to full treatment. Secondly, the result of a univariate
 sensitivity analysis in this work indicates that the price of Phesgo would
 have to increase by 16% so that both treatments cost the same. Thirdly, to
 increase the number of patients, the intravenous treatment would have to
 be totally replace by the Phesgo treatment, since the use of the latter
 requires less personnel and infrastructure.
description: # Data from: Cost-minimization analysis Phesgo model
 [https://doi.org/10.5061/dryad.pc866t1wn](https://doi.org/10.5061/dryad.pc866t1wn) We use public information from the Peruvian social health security. We use the following sources of data: Hospital administrative documents: We retrieved the annual salaries of nurses and pharmaceutical chemists and accessed the list of EsSalud strategic purchases. The latter list included the prices and specific characteristics (size, type, etc.) of drugs, non-drug consumables, and medical equipment for cancer treatment. Finally, the pertuzumab and trastuzumab monthly consumption series and the number of chemotherapy couches were provided by EsSalud. The latter pieces of information were at the hospital level and allowed us to estimate both the number of treated patients and the nationwide attention capacity. Clinical practice guidelines: The HER2-positive metastatic and non-metastatic breast cancer clinical practice guidelines contain the step-by-step process and medication needed for the IV treatment. This information served as an input for the in-depth interviews that were followingly conducted. The processes and variables contained in each tab of the published minimal data set ("Cost minimization analysis for Her2+ metastatic breast cancer") are briefly described below: **Analysis** §  **IV:** Based on the prices and quantities listed above, as well as the delay time for each medical procedure, the total cost per stage of the intravenous treatment scheme is estimated. For this purpose, an estimation by intervals is applied, so that the tab shows the minimum, maximum and average of the calculated times, quantities and costs. §  **SC:** This tab performs an analogous process to the "IV" sheet, but for the subcutaneous treatment scheme. §  **UMO:** This tab performs an analogous process to the "IV" and "SC" sheets, but the procedures in the oncology mixing unit (UMO, for its acronym in Spanish). **Inputs** §  **Sum_Inputs:** This tab lists the inputs required for each treatment scheme and modality in each of the defined treatment stages. It also details the quantities and prices of the respective inputs listed. §  **Assumptions:** Key assumptions for treatment cost estimation are detailed, such as: (i) average patient weight, (ii) personnel costing parameters, (iii) disease prevalence, among others. §  **Non-drug consumables:** The non-drug consumables required for each scheme and treatment stage are listed (prices and quantities). §  **Drug consumables:** The drug consumables required for each scheme and treatment stage are listed (prices and quantities). §  **Wages:** The salaries for each professional category involved in the treatments are listed and the cost per minute of such personnel is estimated. §  **Consumption:** The consumption of Pertuzumab and Trastuzumab in each hospital of the EsSalud network is systematized. Also, based on this consumption, the number of Her2+ breast cancer patients at the national level is estimated. §  **Value of time:** The time value of patients is estimated on the basis of the weighted statistical lifetime value. §  **Data breast cancer:** The participation of each age group in breast cancer care is estimated. The objective is to generate weights for the estimation of a weighted statistical value of life. §  **VEVxAge:** Based on the statistical value of life by age and the shares of age groups in breast cancer care, a weighted statistical value of life is estimated.