Abstract 97P
Background
Tumor Treating Fields (TTFields) + standard therapy (investigator’s choice of docetaxel or immune checkpoint inhibitor [ICI]) significantly prolonged overall survival compared to standard therapy alone in patients with stage IV non-small cell lung cancer (NSCLC) following progression on or after platinum-based therapy. This study aims to estimate the cost-effectiveness of adding TTFields to standard therapy.
Methods
A three-state (stable disease, progressive disease, and death) partitioned survival model was developed from a US payer perspective over a lifetime time horizon. Results from the phase III randomized LUNAR study (TTFields + standard therapy compared to standard therapy alone) were used to estimate long-term overall survival and progression-free survival using parametric extrapolation. A subgroup analysis examined TTFields with docetaxel and an ICI separately. Previously published utilities were used to calculate quality-adjusted life-years (QALYs). Treatment, administration, monitoring, and adverse event costs were sourced from the published fee schedules and MediSpan. Costs and benefits were discounted at 3% per year.
Results
Patients treated with TTFields + standard therapy had a mean lifetime survival of 2.44 years (2.17 discounted) compared to 1.31 (1.26 discounted) for standard therapy-alone. QALYs were 1.78 (1.58 discounted) for TTFields + standard therapy compared to 0.97 (0.93 discounted) for standard therapy-alone. Incremental total costs were $59,217 ($58,505 discounted) higher for TTFields + standard therapy. The incremental cost-effectiveness ratio (ICER) was $89,012 per QALY gained and $64,316 per life-year gained.
Conclusions
This analysis revealed that TTFields + standard therapy is cost-effective compared to standard therapy alone in patients with stage IV NSCLC after platinum-based chemotherapy. Table: 97P
Cost-effectiveness results
| TTFields + standard therapy | Standard therapy | Difference | |
| Discounted costs | |||
| Treatment | $68,431 | $13,986 | $54,445 |
| Administration | $424 | $327 | $97 |
| Supportive care | $5,039 | $2,922 | $2,117 |
| Adverse events | $3,511 | $1,665 | $1,846 |
| Total | $77,406 | $18,901 | $58,505 |
| Discounted Outcomes | |||
| Life-Years | 2.17 | 1.26 | 0.91 |
| QALYs | 1.58 | 0.93 | 0.66 |
| ICER (QALYs) | $89,012 |
Legal entity responsible for the study
Novocure, Inc.
Funding
Novocure, Inc.
Disclosure
R. Kotecha: Financial Interests, Institutional, Research Grant: Medtronic Inc., Blue Earth Diagnostics, Novocure, GT Medical Technologies, AstraZeneca, Viewray Inc., Brainlab, Cantex Pharmaceuticals, Inc., Ion Beam Applications; Financial Interests, Institutional, Advisory Board: Exelixis; Financial Interests, Personal, Advisory Role: Kazia Therapeutics, Elekta AB, Viewray Inc., Castle Biosciences, Novocure; Financial Interests, Personal, Advisory Board: Viewray Medical, GT Medical Technologies, Insightec Ltd, Plus Therapeutics, Inc. W. Furnback: Financial Interests, Personal, Full or part-time Employment: Real Chemistry. E. Wu: Financial Interests, Personal, Full or part-time Employment: Real Chemistry. Y.C. Koh: Financial Interests, Personal, Full or part-time Employment: Novocure; Financial Interests, Personal, Stocks/Shares: Novocure.