Presentation (CTI)

OBJECTIVES: In China, lung cancer is the leading cause of cancer death. Most patients are diagnosed at an advanced stage. MET amplification (METamp) is a key resistance mechanism after EGFR-TKI therapy. Savolitinib-Osimertinib, the first globally approved oral dual-target regimen, significantly improved progression-free survival. This study evaluated its cost-effectiveness versus guideline-recommended Ivonescimab plus chemotherapy for patients with locally advanced or metastatic non-squamous NSCLC harboring MET amplification after progression on EGFR‑TKI therapy.
METHODS: A cost-effectiveness analysis was conducted from a Chinese healthcare perspective. A partitioned survival model with a 3-year horizon was developed, incorporating progression-free, progressed, and death states. Clinical inputs were derived from the SACHI trial, with matched adjusted indirect comparison (MAIC) and risk-ratio extrapolation applied to address between-trial heterogeneity. Direct medical costs (drugs, grade ≥3 AEs) and localized utility values were included. Sensitivity analyses (one-way, probabilistic) and scenario analyses (varying MAIC covariate sets) were performed to test robustness.
RESULTS: Over 3 years, Savolitinib-Osimertinib yielded 1.37 QALYs at a cost of 335,460.02 CNY, compared with 0.52 QALYs at 260,445.32 CNY for chemotherapy-based therapy, resulting in an ICER of 88,122.57 CNY/QALY. This is below China’s willingness-to-pay threshold (1.5 × GDP per capita, 143,625.00 CNY/QALY). The ICER remained cost-effective in 5-year analyses (102,936.14 CNY/QALY). One-way sensitivity analysis identified drug price as the main driver, though ICER stayed under the threshold. Probabilistic sensitivity analysis showed 100% cost-effectiveness probability at the threshold. Scenario analyses with different MAIC adjustments consistently supported economic advantage (ICER 93,178 CNY/QALY).
CONCLUSIONS: Savolitinib-Osimertinib provides significantly improved survival and is cost-effective versus Ivonescimab plus chemotherapy for EGFR‑TKI-resistant, MET-amplified advanced non-squamous NSCLC in China. Findings are robust across multiple sensitivity and scenario analyses, supporting its inclusion in reimbursement lists to enhance patient access. Methodologically, the study demonstrates an approach to address cross-trial heterogeneity in health technology assessment.