Cost-Effectiveness of Tepotinib Versus Docetaxel Monotherapy for Patients With Previously Treated Advanced Non-Small Cell Lung Cancer Harboring METex14 Skipping in Finland

OBJECTIVES: Tepotinib is indicated for the treatment of adult patients with advanced non-small cell lung cancer (NSCLC) harboring alterations leading to mesenchymal-epithelial transition factor gene exon 14 (METex14) skipping, who require systemic therapy following prior treatment with immunotherapy and/or platinum-based chemotherapy. This research aims to assess the cost-effectiveness of tepotinib in the aforementioned indication in the Finnish healthcare setting.

METHODS: The study conducts a cost-utility analysis by building a three-state partitioned survival model, which is used to estimate costs, effects, and an incremental cost-effectiveness ratio (ICER) during a base case time horizon of 25 years. Efficacy, safety, and utility parameters were derived from the Phase II study (VISION), which was the primary data source together with Finnish expert input and cost literature. The KEYNOTE-010 study was used to create a matching-adjusted control arm representing patients receiving docetaxel, the current standard of care in this patient group in Finland. Clinical study results were extrapolated to model progression-free survival and overall survival. Both costs and effects were discounted at a 3% annual discount rate. In addition, a probabilistic sensitivity analysis and scenario analyses were conducted to assess the effect and magnitude of uncertainty.

RESULTS: In the base case analysis, tepotinib treatment achieved 2.23 additional life years (3.61 vs 1.38) and 1.25 (2.11 vs 0.87) quality-adjusted life years (QALY) when compared with docetaxel. The ICER was <2 times the gross domestic product per capita per QALY gained. Sensitivity analyses show that the relative dose intensity of tepotinib, along with parameters relating to subsequent treatment lines, has a significant impact on cost-effectiveness.

CONCLUSIONS: Tepotinib provides a significant clinical improvement in a patient population suffering from a severe form of cancer. In addition, tepotinib is a potentially a cost-effective treatment option when accounting for current treatment practices in Finland.