Presentation (CTI)

OBJECTIVES: Sunvozertinib has exhibited remarkable efficacy in treating advanced non-small cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor exon 20 insertion (EGFR exon20ins) mutations. This study aimed to investigate the cost-effectiveness of sunvozertinib as a second-line treatment for NSCLC patients with EGFR exon20ins mutations from the perspective of Chinese health care systems.
METHODS: A partitioned survival model with three health states (progression free, progressed, or death) was used. The comparator was set as the most commonly used treatment regimen (chemotherapy combined with bevacizumab) in the base case analysis, and as a real-world mixed treatment regimen including PD-1, EGFR-TKIs and chemotherapy in scenario analysis. A willingness-to-pay (WTP) threshold of ¥89,358 per QALY (one times the 2023 GDP per capita of China) was used in the current analysis. Clinical efficacy data of sunvozertinib relative to comparators were derived from unanchored matching adjusted indirect treatment comparisons. Utility data and costs were obtained from the published literature or official websites. Costs and benefits were discounted at an annual rate of 5%. Model robustness was evaluated with deterministic and probabilistic sensitivity analyses.
RESULTS: In the base case analysis, a gain of 1.27 quality-adjusted life years (QALYs) was achieved, with incremental costs amounting to ¥79,865. This led to an incremental cost-effectiveness ratio (ICER) of ¥62,976 per QALY. In the scenario analysis, the ICER was ¥77,147 per QALY with a gain of 0.94 QALYs and the incremental costs of ¥72,455. In the base case, the probability of sunvozertinib being cost-effective was 94.40% under the threshold of ¥89,358 per QALY.
CONCLUSIONS: Sunvozertinib presents a cost-effective regimen as a second-line treatment for NSCLC patients with EGFR exon20ins Mutation. The scenario analysis and sensitivity analysis verify the robustness of the base case result.