THE BUDGET IMPACT OF TUMOR-TREATING FIELDS PLUS GEMCITABINE AND NAB-PACLITAXEL FOR FRONT-LINE TREATMENT OF LOCALLY ADVANCED PANCREATIC CANCER
Author(s)
Greg F. Guzauskas, MSPH, PhD1, Jorge F. Nino de Rivera Guzman, MSc2, Bruce Wang, PhD3.
1The CHOICE Institute, Orcas, WA, USA, 2Health Economy specialist, Novocure, Glendale, CO, USA, 3Elysia Group, LLC, New York, NY, USA.
1The CHOICE Institute, Orcas, WA, USA, 2Health Economy specialist, Novocure, Glendale, CO, USA, 3Elysia Group, LLC, New York, NY, USA.
OBJECTIVES: To estimate the 5-year budget impact of adding Tumor Treating Fields (TTFields) to first-line gemcitabine and nab-paclitaxel for locally advanced pancreatic cancer (LAPC) in a US private payer population.
METHODS: A 1-million-member health plan was modeled using a rolling-cohort budget impact framework. Monthly incident LAPC cohorts entered the model and accumulated costs until progression or death. Survival was based on exponential OS and distal PFS functions fit to PANOVA-3 medians. Costs included TTFields device costs, chemotherapy, progression-free care, progressed-disease care, and end-of-life care. TTFields market share increased from 5% in Year 1 to 25% in Year 5. The analysis compared a Without TTFields scenario (all patients receive SOC alone) with a With TTFields scenario, in which a proportion of patients received TTFields+SOC according to adoption rates.
RESULTS: The health plan was projected to have 132 newly diagnosed LAPC patients over 5 years, with total costs of $8.57M in the Without TTFields scenario. With TTFields available, 20 patients received TTFields+SOC at a cost of $4.32M, while SOC-only costs declined to $7.14M, yielding total 5-year spending of $11.46M. The incremental cost per member per month was $0.0482. Incremental costs were primarily driven by TTFields device expenditures ($2.02M), which accounted for most of the overall $2.89M increase. Smaller cost increases in SOC chemotherapy and progression-free care reflected longer survival and additional time on treatment. These increases were partially offset by reductions in progressed-disease (-$0.76M) and end-of-life (-$12K) costs owing to delayed progression in the TTFields arm.
CONCLUSIONS: TTFields adoption increases payer spending due to device costs but reduces high-cost progressed-disease and end-of-life care. Overall PMPM impact is small relative to a typical health plan budget, and the combination of modest incremental costs and downstream savings supports the financial feasibility of adopting TTFields for LAPC.
METHODS: A 1-million-member health plan was modeled using a rolling-cohort budget impact framework. Monthly incident LAPC cohorts entered the model and accumulated costs until progression or death. Survival was based on exponential OS and distal PFS functions fit to PANOVA-3 medians. Costs included TTFields device costs, chemotherapy, progression-free care, progressed-disease care, and end-of-life care. TTFields market share increased from 5% in Year 1 to 25% in Year 5. The analysis compared a Without TTFields scenario (all patients receive SOC alone) with a With TTFields scenario, in which a proportion of patients received TTFields+SOC according to adoption rates.
RESULTS: The health plan was projected to have 132 newly diagnosed LAPC patients over 5 years, with total costs of $8.57M in the Without TTFields scenario. With TTFields available, 20 patients received TTFields+SOC at a cost of $4.32M, while SOC-only costs declined to $7.14M, yielding total 5-year spending of $11.46M. The incremental cost per member per month was $0.0482. Incremental costs were primarily driven by TTFields device expenditures ($2.02M), which accounted for most of the overall $2.89M increase. Smaller cost increases in SOC chemotherapy and progression-free care reflected longer survival and additional time on treatment. These increases were partially offset by reductions in progressed-disease (-$0.76M) and end-of-life (-$12K) costs owing to delayed progression in the TTFields arm.
CONCLUSIONS: TTFields adoption increases payer spending due to device costs but reduces high-cost progressed-disease and end-of-life care. Overall PMPM impact is small relative to a typical health plan budget, and the combination of modest incremental costs and downstream savings supports the financial feasibility of adopting TTFields for LAPC.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE145
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Oncology, SDC: Rare & Orphan Diseases