Cost-Effectiveness Analysis of Lenvatinib vs Key Comparators in First-Line Unresectable Hepatocellular Carcinoma in Canada
Author(s)
Kerigo Ndirangu, MPH1, Shivani Kamdar, PhD2, Alice Li, MBiotech3, Mark Pennington, PhD4, Jack Scerri, MSc4, David Trueman, BSc, MSc4.
1Eisai Inc, Nutley, NJ, USA, 2PIVINA Consulting Inc, Mississauga, ON, Canada, 3Eisai Ltd, Mississauga, ON, Canada, 4Source Health Economics, London, United Kingdom.
1Eisai Inc, Nutley, NJ, USA, 2PIVINA Consulting Inc, Mississauga, ON, Canada, 3Eisai Ltd, Mississauga, ON, Canada, 4Source Health Economics, London, United Kingdom.
Presentation Documents
OBJECTIVES: Cost-effectiveness (CE) studies have previously found lenvatinib (LEN) to be cost-effective in unresectable hepatocellular carcinoma (uHCC). The recently conducted study LEAP-002 found median overall survival for LEN of 19.0 months, which was longer than observed during the pivotal REFLECT trial (13.6 months). Including the more recent data from LEAP-002, this CE analysis updates estimates for LEN in untreated uHCC from a Canadian health care system perspective.
METHODS: A partitioned survival model was used to extrapolate costs and quality-adjusted life-years (QALYs) over a lifetime time horizon. Utility values were derived from EQ-5D-5L collected in LEAP-002, and costs taken from published sources. LEN was compared against therapies recommended and funded for the treatment of uHCC in Canada: sorafenib (SOR), tremelimumab plus durvalumab (TREM+DURV), and atezolizumab plus bevacizumab (ATEZ+BEV). Relative efficacy was taken from a network meta-analysis which pooled data from LEAP-002 and REFLECT.
RESULTS: LEN was associated with cost savings of $3,299 and 0.52 additional QALYs when compared to SOR and cost savings of $95,724 and 0.14 additional QALYs when compared to TREM+DURV, therefore LEN was considered a dominant strategy against both treatments. Compared to ATEZ+BEV, LEN was associated with cost savings of $130,603 and 0.20 fewer QALYs, with an incremental cost-effectiveness ratio (ICER) of $642,499/QALY, implying that LEN is cost-effective at conventional willingness to pay thresholds. When considering a societal perspective, LEN remained the dominant strategy compared to SOR, and was cost-effective compared to TREM+DURV and ATEZ+BEV.
CONCLUSIONS: These results suggest that LEN is a cost-effective treatment option for patients with uHCC in Canada. Results were robust to changes in key assumptions when sensitivity analyses were performed.
METHODS: A partitioned survival model was used to extrapolate costs and quality-adjusted life-years (QALYs) over a lifetime time horizon. Utility values were derived from EQ-5D-5L collected in LEAP-002, and costs taken from published sources. LEN was compared against therapies recommended and funded for the treatment of uHCC in Canada: sorafenib (SOR), tremelimumab plus durvalumab (TREM+DURV), and atezolizumab plus bevacizumab (ATEZ+BEV). Relative efficacy was taken from a network meta-analysis which pooled data from LEAP-002 and REFLECT.
RESULTS: LEN was associated with cost savings of $3,299 and 0.52 additional QALYs when compared to SOR and cost savings of $95,724 and 0.14 additional QALYs when compared to TREM+DURV, therefore LEN was considered a dominant strategy against both treatments. Compared to ATEZ+BEV, LEN was associated with cost savings of $130,603 and 0.20 fewer QALYs, with an incremental cost-effectiveness ratio (ICER) of $642,499/QALY, implying that LEN is cost-effective at conventional willingness to pay thresholds. When considering a societal perspective, LEN remained the dominant strategy compared to SOR, and was cost-effective compared to TREM+DURV and ATEZ+BEV.
CONCLUSIONS: These results suggest that LEN is a cost-effective treatment option for patients with uHCC in Canada. Results were robust to changes in key assumptions when sensitivity analyses were performed.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE372
Topic
Economic Evaluation
Disease
SDC: Oncology