THE BUDGET IMPACT OF INTRODUCING ZONGERTINIB INTO THE FORMULARY FOR TREATMENT-NAÏVE AND PRETREATED HER2-MUTANT ADVANCED NSCLC IN THE UNITED STATES
Author(s)
Hasan Basarir, PhD1, Tom Clemmet, MSc1, Wei-Han Cheng, PhD2, Ravi A. Patel, MS, PharmD2, Heiko Zettl, PhD3.
1RTI Health Solutions, Manchester, United Kingdom, 2Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA, 3Boehringer Ingelheim International GmbH, Ingelheim, Germany.
1RTI Health Solutions, Manchester, United Kingdom, 2Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA, 3Boehringer Ingelheim International GmbH, Ingelheim, Germany.
OBJECTIVES: Zongertinib is an irreversible tyrosine kinase inhibitor that selectively inhibits HER2 while sparing wild-type EGFR, thereby minimizing associated toxicities. Zongertinib was approved in the USA (accelerated), China (conditional), and Japan for previously treated patients with HER2(ERBB2)-mutant advanced/metastatic NSCLC A budget-impact model was developed to estimate the budgetary impact of introducing zongertinib to a US health plan formulary.
METHODS: The budget impact analysis was conducted from the perspective of a hypothetical US health plan with 1 million members, equally split between Medicare and commercial health insurance beneficiaries. Other treatment options were chemotherapy, immunotherapy as monotherapy, chemotherapy + immunotherapy, fam-trastuzumab deruxtecan (T-DXd) and sevabertinib, the latter two being considered for patients who received prior systemic therapy only. Drug acquisition, drug administration, adverse event, monitoring/supportive therapy, progressed disease, and terminal care costs were considered over a 2-year time horizon. Trial data were used to inform duration of treatment, post-progression period, and adverse event rates.
RESULTS: Eleven treatment-naïve patients and 7 patients receiving prior systemic therapy were eligible to be treated with zongertinib each year. The introduction of zongertinib resulted in a budget impact per member per month of $0.0387 in year 1 and $0.0588 in year 2, partly offset by cost savings due to zongertinib’s oral administration, manageable safety profile, lower monitoring/supportive therapy requirements, and lower progressed disease costs. Zongertinib was associated with the lowest total cost of care per patient per month of treatment in patients who received prior systemic therapy, $9,295 and $12,212 lower than T-DXd and sevabertinib, respectively.
CONCLUSIONS: The introduction of zongertinib into the formulary for treatment-naïve and previously treated patients with HER2-mutant advanced NSCLC is associated with a limited budgetary impact in the US.
METHODS: The budget impact analysis was conducted from the perspective of a hypothetical US health plan with 1 million members, equally split between Medicare and commercial health insurance beneficiaries. Other treatment options were chemotherapy, immunotherapy as monotherapy, chemotherapy + immunotherapy, fam-trastuzumab deruxtecan (T-DXd) and sevabertinib, the latter two being considered for patients who received prior systemic therapy only. Drug acquisition, drug administration, adverse event, monitoring/supportive therapy, progressed disease, and terminal care costs were considered over a 2-year time horizon. Trial data were used to inform duration of treatment, post-progression period, and adverse event rates.
RESULTS: Eleven treatment-naïve patients and 7 patients receiving prior systemic therapy were eligible to be treated with zongertinib each year. The introduction of zongertinib resulted in a budget impact per member per month of $0.0387 in year 1 and $0.0588 in year 2, partly offset by cost savings due to zongertinib’s oral administration, manageable safety profile, lower monitoring/supportive therapy requirements, and lower progressed disease costs. Zongertinib was associated with the lowest total cost of care per patient per month of treatment in patients who received prior systemic therapy, $9,295 and $12,212 lower than T-DXd and sevabertinib, respectively.
CONCLUSIONS: The introduction of zongertinib into the formulary for treatment-naïve and previously treated patients with HER2-mutant advanced NSCLC is associated with a limited budgetary impact in the US.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE377
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies, Trial-Based Economic Evaluation
Disease
SDC: Oncology