Presentation (CTI)

OBJECTIVES: MET exon 14 skipping mutation non-small cell lung cancer (NSCLC) is often associated with advanced disease stage and poor prognosis. This study aimed to evaluate the cost-effectiveness of savolitinib, a selective MET tyrosine kinase inhibitor, versus glumetinib used as first-line treatment for locally advanced or metastatic NSCLC harboring MET exon 14 skipping mutation from Chinese healthcare system perspective.
METHODS: A three-health-state partitioned survival model including progression-free survival (PFS), post-progression (PD), and death was performed. A 5-year time horizon was modeled to reflect the indication's rapid disease progression; this duration was deemed an effective lifetime horizon as it captured most of the cohort's mortality. In the absence of head-to-head trials, unanchored matching adjusted indirect comparison (MAIC) was used for survival analyses based on individual patient data from trial (NCT04923945) for savolitinib and aggregated data from trial (NCT04270591) for glumetinib, which accounted for differences in patients’ baseline characteristics between two trials. The utility values were derived from published literature. The prices of savolitinib and glumetinib were determined based on the national drug price negotiation in 2024. Resource utilization was derived from expert clinical interviews. Health outcomes and costs were discounted at 5% annually. Outcome measures were reported in incremental cost-effectiveness ratios (ICERs). Both one-way and probabilistic sensitivity analyses were conducted.
RESULTS: In the base-case analysis, the 5-year model projected a total cost of ¥327,126 with 1.99 QALYs for savolitinib versus ¥347,195 with 1.79 QALYs for glumetinib. savolitinib was associated with lower total costs (-¥20,069) and higher QALYs (+0.19), making it a dominant strategy. Additionally, one-way and probabilistic sensitivity analyses confirmed the robustness of the results.
CONCLUSIONS: Savolitinib is a dominant and cost-effective option compared to glumetinib for first-line treatment of MET exon 14-mutated advanced NSCLC in China, demonstrating both improved health outcomes and cost savings, which was verified in sensitivity analyses.