Cost-Effectiveness of Tumor-Treating Fields in Combination With Temozolomide for Glioblastoma Patients: An Italian Healthcare System Perspective
Author(s)
Jorge F. Nino de Rivera Guzman, MSc1, Julia Borgel, PharmD2, Bruce Wang, PhD3.
1Health Economy specialist, Novocure, Glendale, CO, USA, 2Novocure, Paris, France, 3Novocure, Portsmouth, NH, USA.
1Health Economy specialist, Novocure, Glendale, CO, USA, 2Novocure, Paris, France, 3Novocure, Portsmouth, NH, USA.
Presentation Documents
OBJECTIVES: Tumor-Treating Fields (TTFields) have demonstrated improved survival outcomes when combined with temozolomide (TMZ) during the maintenance phase for glioblastoma (GBM) patients. The EF-14 trial showed TTFields + TMZ achieved a median progression-free survival (PFS) of 6.7 months vs. 4 months and overall survival of 20.9 months vs. 16 months with TMZ alone. This study evaluates the cost-effectiveness of adding TTFields to TMZ from the perspective of the Italian healthcare system.
METHODS: A partitioned survival model, using parametric survival curves fitted to EF-14 trial data, evaluated TTFields + TMZ versus TMZ monotherapy in newly diagnosed GBM patients over a 30-year horizon. The model included three health states: PFS, progressive disease, and death. Clinical inputs, including survival probabilities and treatment duration, were sourced from the EF-14 trial. Health-state utilities were derived from Garside et al. Costs, expressed in 2023 Euros, sourced from Italian data included drug acquisition, adverse events, progression, and end-of-life care. The cost of TTFields therapy was €21,000 per month. Sensitivity analyses assessed the robustness of results, focusing on variations in utilities, costs, and time horizon. Costs and outcomes were discounted at 3% annually.
RESULTS: TTFields + TMZ delivered 1.75 additional Life Years (LYs) and 1.34 more Quality-Adjusted Life Years (QALYs) versus TMZ monotherapy, with incremental costs of €171,661. Incremental cost-effectiveness ratios (ICERs) were €98,088/LY and €128,503/QALY. The main cost driver was TTFields acquisition (€196,472), partially offset by savings in end-of-life costs (€-33,303). Total costs amounted to €629,180 for TTFields + TMZ versus €457,519 for TMZ alone. Sensitivity analyses identified TTFields acquisition costs as the primary driver, with incremental costs ranging from €162,136 to €175,893 in varying scenarios.
CONCLUSIONS: Adding TTFields to TMZ improves survival and quality of life for GBM patients. While associated with increased costs, the therapy offers significant clinical benefits that may support its inclusion in the Italian healthcare system.
METHODS: A partitioned survival model, using parametric survival curves fitted to EF-14 trial data, evaluated TTFields + TMZ versus TMZ monotherapy in newly diagnosed GBM patients over a 30-year horizon. The model included three health states: PFS, progressive disease, and death. Clinical inputs, including survival probabilities and treatment duration, were sourced from the EF-14 trial. Health-state utilities were derived from Garside et al. Costs, expressed in 2023 Euros, sourced from Italian data included drug acquisition, adverse events, progression, and end-of-life care. The cost of TTFields therapy was €21,000 per month. Sensitivity analyses assessed the robustness of results, focusing on variations in utilities, costs, and time horizon. Costs and outcomes were discounted at 3% annually.
RESULTS: TTFields + TMZ delivered 1.75 additional Life Years (LYs) and 1.34 more Quality-Adjusted Life Years (QALYs) versus TMZ monotherapy, with incremental costs of €171,661. Incremental cost-effectiveness ratios (ICERs) were €98,088/LY and €128,503/QALY. The main cost driver was TTFields acquisition (€196,472), partially offset by savings in end-of-life costs (€-33,303). Total costs amounted to €629,180 for TTFields + TMZ versus €457,519 for TMZ alone. Sensitivity analyses identified TTFields acquisition costs as the primary driver, with incremental costs ranging from €162,136 to €175,893 in varying scenarios.
CONCLUSIONS: Adding TTFields to TMZ improves survival and quality of life for GBM patients. While associated with increased costs, the therapy offers significant clinical benefits that may support its inclusion in the Italian healthcare system.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE261
Topic
Economic Evaluation
Disease
SDC: Oncology