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Guenka Petrova* and Maria Dimitrova


This study reviews the existing evidences for denosumab usage for bone metastases therapy in breast cancer and evaluates its budget impact on the health care system in Bulgaria. Perspective of the analysis is from the third party payer that is the National Health Insurance fund. Desktop study of RCT for safety and efficacy of denosumab in comparison with zolendronic acid, as well as budget impact analysis were performed for breast cancer with metastases therapy. The results show that denosumab is effective and safe therapy for persons with breast cancer. The cost of administration of denosumab is higher in comparison with zolendronic acid, due to its high price but the administration cost of zolendroni acid as an infusion is higher. Administration costs are partly offset by the patients management cost and cost of skeletal events. Savings from denosumab utilization are increasing with the years even if the number of patients with metastases is very low in comparison with other countries. Savings are increasing from 79 to 240 thousands BGN in the 1srt and 3rd year, respectively. Based on this study we can conclude that denosumab is effective, safe, and it is a good investment for the Bulgarian health care settings when treated breast cancer with metastases.

Keywords: Denosumab, zolendronic acid, breast cancer, metastases, budget impact analysis.

[Full Text Article]

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