Budget-Impact Analysis of Encorafenib Plus Binimetinib as a Treatment for Advanced NSCLC With BRAFV600-Mutation in Older Adults From Argentina

OBJECTIVES: This study describes the budget impact of the reimbursement of encorafenib+binimetinib (a BRAF-MEK inhibitor) for the treatment of advanced non-small cell lung cancer (aNSCLC) BRAFV600E mutated (BRAF-m) adult patients from the National Institute of Social Services for Retirees and Pensioners (INSSJP-PAMI) perspective in Argentina.

METHODS: PAMI provides social and healthcare services to around 80% of the elderly population nationwide. The budget-impact analysis was conducted using PAMI health subsystem perspective over three years, comparing chemotherapy, anti-PD-1 and other BRAF-MEK inhibitors (dabrafenib+trametinib) vs encorafenib+binimetinib. Key parameters were inputted based on published evidence and local expert opinion. Costs were expressed in 2024 US Dollars (average exchange rate: $873, May 2024).

RESULTS: The number of patients potentially treated with BRAF-m aNSCLC was estimated at 104 for 3 years. Considering increasing annual market shares from 35% to 54%, 47 (45%) of them would be receiving encorafenib+binimetinib treatment in total, starting at 12 patients and reaching 19 in the third year. The incorporation of encorafenib+binimetinib was associated with total savings of USD 28.725 for PAMI in the first year, mainly explained by lower drug acquisition costs. As the number of patients receiving p BRAF-MEK inhibitors increases in years 2 and 3 of the analysis, costs rise with a total budget impact in 3 years of USD 653.459, primarily due to drug acquisition costs. Adverse events management and drug administration costs still represent savings for PAMI in the three-year analysis, as encorafenib + binimetinib is administered orally and presents a better safety profile than the other therapeutic options. These resources would then be available for other patients.

CONCLUSIONS: This analysis indicates that incorporating more patients into BRAF-MEK inhibitor therapies requires an investment from PAMI. The availability of encorafenib+binimetinib generates savings in adverse events management, reducing the healthcare resources allocated for the treatment of BRAF-m aNSCLC patients.