OBJECTIVES: : Commonly manifested as neutropenia, anemia, and thrombocytopenia, CIM is a major complication of systemic chemotherapy. We evaluated the economic impact of trilaciclib, a first-in-class breakthrough therapy that protects multiple hematopoietic lineages simultaneously against CIM in adult patients with ES-SCLC receiving platinum/etoposide- or topotecan-containing chemotherapy from both US provider and patient-caregiver perspectives.

METHODS: An economic model for both perspectives estimated the impact of administering trilaciclib prior to first- and second-line chemotherapy in patients with ES-SCLC over a 3-year time horizon, comparing “with” and “without” trilaciclib scenarios. Clinical and cost inputs (inflation-adjusted to 2021) were derived from published literature and trilaciclib clinical trial data. Model outcomes included number of grade 3/4 myelosuppressive adverse events (AEs), healthcare resource use, prophylaxis and AE management costs, and total costs (provider perspective), and productivity loss and out-of-pocket costs (patient-caregiver perspective). Estimated total costs per trilaciclib-eligible patient were compared between “with” and “without” scenarios.

RESULTS: The “with” trilaciclib scenario was estimated to reduce myelosuppressive AEs over a 3-year period (events avoided per patient: 0.42 for neutropenia, 0.02 for febrile neutropenia, 0.06 for anemia, and 0.14 for thrombocytopenia) and healthcare resource use (events avoided per patient: 0.28 for outpatient visits, 0.04 for red blood cell transfusion, 0.05 for platelet transfusion, 0.51 for hospitalization, and 0.28 for emergency room visits) compared with the “without” scenario. From the provider perspective, the projected total cost savings associated with the introduction of trilaciclib were $952, $3111, and $4592 per patient in years 1-3, respectively. The projected cost savings from the patient-caregiver perspective were $336, $1099, and $1621 per patient in years 1-3, respectively.

CONCLUSIONS: The findings suggest that the use of trilaciclib prior to chemotherapy in patients with ES-SCLC can be cost-beneficial owing to fewer myelosuppressive AEs, less healthcare resource use, and lower costs for both US provider and patient-caregiver perspectives.