2SPD-005 Economic analysis of osimertinib in previously untreated EGFR mutant advanced non-small cell lung cancer

Background and importanceOsimertinib improves progression free survival (PFS) in previously untreated patients with EGFR mutated non-small cell lung cancer (NSCLC). However, its profitability has not been established in a third level hospital.Aim and objectivesThe aim of the study was to evaluate the cost effectiveness of osimertinib in patients with mutated EFGR NSCLC compared with other tyrosine kinase inhibitors (TKIs).Material and methodsThis was a cost effectiveness study of osimertinib in patients with EFGR mutated NSCLC in a third level hospital over a period of 1 year of treatment (1 January 2018 to 12 January 2019). The protocol of the hospital was reviewed to include all therapeutic alternatives: afatinib, gefitinib and erlotinib.The main variable of the study was the incremental cost effectiveness ratio (ICER) of osimertinib compared with other TKIs. Secondary variables included: cost of treatment per month (€), efficacy (life months gained), total cost of treatment (€) and incremental cost of osimertinib compared with other TKIs.ResultsAbstract 2SPD-005 Table 1 Osimertinib Erlotinib Gefitinib Afatinib Dosage (mg/24 hours) 80 150 250 40 Cost of treatment/month (€) 4313 2045 1227 1964 Total cost of treatment (€) 81 516* 22 904** 12 515* 20 033 * Incremental cost of osimertinib compared with other TKIs (€) Reference drug Δ58 612 69 001 Δ61 483 Effectiveness (progression free survival) (months) 18.9† 10.4†† 10.2† 10.2† *PFS FLAURA study; **PFS EURTAC study; †FLAURA study; ††EURTAC study.The incremental cost effectiveness ratios of osimertinib compared with each TKI were:Osimertinib versus erlotinib: €6896/month of PFS.Osimertinib versus gefitinib: €7931/month of PFS.Osimertinib versus afatinib: €7067/month of PFS.Conclusion and relevanceAt the current commercialised price, firstline osimertinib therapy in patients with EGFR mutant NSCLC would mean an incremental cost of €7455±€439 per month of PFS gained compared with other TKIs. If we consider a year of treatment, the incremental cost of osimertinib would be an additional €74547±4388. The reduction in cost of osimertinib would significantly improve its cost effectiveness profile. The main limitation of this study was that the cost of the complete treatment was calculated using the drug’s PVL.References and/or acknowledgementsNo conflict of interest.