Cost Evaluation of Adjunctive Osimertinib Use in Resected EGFR-Positive NSCLC

The current study evaluated the cost-effectiveness and utility of post-resection adjunctive osimertinib for patients with stages IB, II, and IIIA EGFR-positive non–small-cell lung cancer (NSCLC).

In this analysis, life-years (LYs) or quality-adjusted life-years (QALYs) were used as outcomes in the 2-health state Markov model for each stage (IB, II, IIIA). The model used a 3-year time frame for osimertinib; US payer perspective and 3% discount rate were applied, drug costs were per Redbook, and wholesale acquisition cost and monitoring costs were from published data.

By base-case analysis using LY or QALY as outcomes, the incremental costs were lowest for stage II disease. Using LY as an outcome, incremental cost-effectiveness ratio/disease-free survival LY gained in the base case for stage IB was $1.3 million, for stage II was $636,913, and for stage IIIA was $1.2 million. Using QALY as an outcome, the incremental cost-utility ratio/disease-free survival QALY gained in the base case was $1.9 million for stage IB, $950,616 for stage II, and $1.8 million for stage IC.

These results indicate that the cost burden of adjunctive osimertinib therapy was substantially higher than the observed clinical benefit for patients with resected EGFR-positive NSCLC; cost-effectiveness of osimertinib varied across disease stages, with more incremental benefit of osimertinib in stage IIB than stage IB and stage IIIA.

Source: Choi B, et al. J Clin Oncol. 2021;39(suppl 15):Abstract 8525.