Cost Comparison of Osimertinib Plus Chemotherapy Versus Amivantamab Plus Lazertinib for the First-Line Treatment of Patients With Locally Advanced or Metastatic EGFR-Mutated NSCLC
Author(s)
Harry Freeman, MSc1, Elysia Upton, MSc2, Pritesh S. Karia, PhD3, Yanique Rattigan-Brown, PhD, MBA3, Natalie Hearmon, DPhil1, Emily Procter, MSc1, Jorge J Nieva, MD4;
1Costello Medical, London, United Kingdom, 2AstraZeneca, Cambridge, United Kingdom, 3AstraZeneca, Gaithersburg, MD, USA, 4University of Southern California, Norris Cancer Center, Los Angeles, CA, USA
1Costello Medical, London, United Kingdom, 2AstraZeneca, Cambridge, United Kingdom, 3AstraZeneca, Gaithersburg, MD, USA, 4University of Southern California, Norris Cancer Center, Los Angeles, CA, USA
OBJECTIVES: Novel first-line combination regimens offer improvedefficacy for patients with epidermal growth factor receptor-mutated (EGFRm)locally advanced or metastatic non-small cell lung cancer (NSCLC), but acomprehensive evaluation of their costs has not been performed. We estimatedthe total and differential costs of first-line osimertinib plus platinum-basedchemotherapy and intravenous amivantamab plus lazertinib from a United States(US) payer perspective.
METHODS: A cost-comparison calculator was developed to assess treatmentacquisition, administration, disease management, and adverse event management costsfrom both the private and Medicare perspectives. The calculator includedpatients with EGFRm (exon 19 deletion or exon 21 L858R mutation) locallyadvanced or metastatic NSCLC, with the number of patients entering the modelestimated using published US epidemiological data. Adverse events wereidentified from the FLAURA2 and MARIPOSA clinical trials, with all costs sourcedfrom public and commercial data. A one-year treatment duration was assumed forthe treat-to-progression components of both regimens.
RESULTS: The total number of patients estimated to be eligible fortreatment from the private and Medicare perspectives was 2,833 and 2,234,respectively. The total first-year cost per-patient for osimertinib pluschemotherapy (private: $235,709; Medicare: $79,348) was approximately 3-foldlower than that of amivantamab plus lazertinib (private: $662,200; Medicare: $220,129),translating to cost savings of $426,491 per-patient for private payers and $140,781per-patient for Medicare when using osimertinib plus chemotherapy over amivantamabplus lazertinib.The largest cost savings per-patient for osimertinibplus chemotherapy over amivantamab plus lazertinib were in the treatmentacquisition (private: $340,154; Medicare: $106,329), treatment administration (private:$77,972; Medicare: $29,535), and adverse event management (private: $8,137;Medicare: $4,830) categories.
CONCLUSIONS: From a US payer perspective,osimertinib plus chemotherapy is associated with significantly lower overallcosts compared to amivantamab plus lazertinib for the treatment of patientswith EGFRm locally advanced or metastatic NSCLC.
METHODS: A cost-comparison calculator was developed to assess treatmentacquisition, administration, disease management, and adverse event management costsfrom both the private and Medicare perspectives. The calculator includedpatients with EGFRm (exon 19 deletion or exon 21 L858R mutation) locallyadvanced or metastatic NSCLC, with the number of patients entering the modelestimated using published US epidemiological data. Adverse events wereidentified from the FLAURA2 and MARIPOSA clinical trials, with all costs sourcedfrom public and commercial data. A one-year treatment duration was assumed forthe treat-to-progression components of both regimens.
RESULTS: The total number of patients estimated to be eligible fortreatment from the private and Medicare perspectives was 2,833 and 2,234,respectively. The total first-year cost per-patient for osimertinib pluschemotherapy (private: $235,709; Medicare: $79,348) was approximately 3-foldlower than that of amivantamab plus lazertinib (private: $662,200; Medicare: $220,129),translating to cost savings of $426,491 per-patient for private payers and $140,781per-patient for Medicare when using osimertinib plus chemotherapy over amivantamabplus lazertinib.The largest cost savings per-patient for osimertinibplus chemotherapy over amivantamab plus lazertinib were in the treatmentacquisition (private: $340,154; Medicare: $106,329), treatment administration (private:$77,972; Medicare: $29,535), and adverse event management (private: $8,137;Medicare: $4,830) categories.
CONCLUSIONS: From a US payer perspective,osimertinib plus chemotherapy is associated with significantly lower overallcosts compared to amivantamab plus lazertinib for the treatment of patientswith EGFRm locally advanced or metastatic NSCLC.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE398
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology