Presentation (CTI)

OBJECTIVES: Lenvatinib and Sorafenib are routinely used in the treatment of patients with Radioiodine-Refractory Differentiated Thyroid Cancer (RR-DTC). The objective of this study is to estimate the gross budget of utilizing Lenvatinib for the treatment of RR-DTC in the United States (US).
METHODS: Epidemiology data were sourced from the SEER database and published studies. First-line treatments for RR-DTC in the US include Lenvatinib and Sorafenib, with market shares based on sales data from Eisai Inc. and Bayer AG. Safety and dosage data were from phase III trials. Drug prices were obtained from the US Department of Veterans Affairs for sorafenib and Eisai Inc. for Lenvatinib. Adverse event and monitoring costs were based on local tariffs. A 5-year Excel model was developed from the payer perspective to evaluate the gross budget (total costs) of Lenvatinib in the RR-DTC treatment landscape.
RESULTS: Using DTC prevalence and metastatic RR-DTC incidence rates for the US population over 18 years, the model estimated an eligible patient cohort of 46,904 (2024) to 47,659 (2028) over 5 years. The gross budget for Lenvatinib and Sorafenib over 5 years is approximately 40.5 billion USD and 781 million USD, respectively, with per patient per member (PPPM) costs of 146,700 USD for Lenvatinib and 102,999 USD for Sorafenib. Sensitivity analysis indicated that Lenvatinib's cost had the most significant impact on the results.
CONCLUSIONS: This gross budget analysis indicates that introducing Lenvatinib for RR-DTC patients would significantly increase total healthcare costs over the next 5 years, though it may offer superior outcomes compared to sorafenib. With additional survival benefits, Lenvatinib is an effective and essential therapy for the RR-DTC population in the US.