Budget impact analysis of tocilizumab in progressive fibrosing interstitial lung disease

BACKGROUND: Interstitial lung disease (ILD) is a heterogeneous group of diseases characterized by inflammation and fibrosis of the lung parenchyma. A subset of ILD, which is called progressive fibrosing interstitial lung disease (PFILD) develop severe and progressive fibrosing phenotype. PF-ILD is commonly treated with corticosteroids, anti-inflammatory and immunosuppressive therapies. Here, a budget impact analysis on the introduction of tocilizumab for PFILD treatment was conducted. METHODS: The model consists of current scenario (without tocilizumab) and new scenario (with tocilizumab). The market shares of each drug were estimated by the experts. The model was conducted from Ministry of Health (MOH) perspective over 3 years. The cost of the drugs, laboratory test and procedures were obtained from the government pro-curement price. RESULTS: The model estimated that there will be additional cost of RM384,613.44 over 3 years, which corresponds to 0.01% increase of the overall budget. The total number of hospitalizations remain similar between current and new scenario. The cost of tocilizumab and the diagnosed rate are the two most sensitive factors in the model. CONCLUSIONS: Based on these analyses, tocilizumab will add RM384,613.44 over 3 years, which corresponds to 0.01% increase of the overall budget. Tocilizumab will add more options for the physicians in their treatment for PFILD patients. However, more clinical trials are needed to assess the efficacy and safety of tocilizumab in other variants of PFILD.