THE BUDGET IMPACT OF TUMOR-TREATING FIELDS PLUS STEREOTACTIC RADIOSURGERY AND BEST SUPPORTIVE CARE FOR TREATING 1-10 BRAIN METASTASES DUE TO NON-SMALL CELL LUNG CANCER (NSCLC)
Author(s)
Greg 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: The METIS trial is a randomized, phase 3 study evaluating Tumor Treating Fields (TTFields) plus stereotactic radiosurgery (SRS) versus SRS alone for patients with 1-10 brain metastases from non-small cell lung cancer (NSCLC). Our objective was to estimate the 5-year budget impact of adding TTFields to SRS plus supportive care for newly diagnosed inoperable NSCLC brain metastases in a US payer population.
METHODS: A decision-analytic budget impact model was developed for a 1-million-member commercial health plan. Monthly incident cohorts entered the model and were tracked until intracranial progression or death. Intracranial-progression probabilities were derived from METIS 12- and 24-month outcomes, with mortality assumed equivalent across arms. Costs (2025 USD) included TTFields device costs, SRS costs, intracranial-progression care, stable-disease supportive care, salvage therapies, and end-of-life care. TTFields market share increased from 5% to 25% over 5 years. The analysis compared a Without TTFields scenario (SRS + supportive care alone) with a With TTFields scenario reflecting partial adoption. Outcomes included total costs and incremental PMPM, PMPQ, and PMPY. One-way sensitivity analyses varied inputs ±25%.
RESULTS: The model projected 48 annual NSCLC brain-metastasis cases, with up to 12 TTFields-eligible patients by Year 5. In the Without TTFields scenario, 5-year spending was largely composed of intracranial-progression care ($14.7M). With TTFields, device costs totaled $2.1M and intracranial-progression costs declined to $13.7M, resulting in a net difference of $1.2M. Incremental PMPM, PMPQ, and PMPY were $0.0194, $0.0583, and $0.2330. Decreased progression-related costs partially offset device expenditures. Key sensitivity drivers were repeat SRS cost, TTFields monthly cost and duration, and progression-probability inputs.
CONCLUSIONS: TTFields adoption produces a small increase in overall payer spending, while reductions in intracranial-progression costs provide notable offsets. The resulting PMPM impact is minimal, supporting the budgetary feasibility of TTFields use for NSCLC brain metastases.
METHODS: A decision-analytic budget impact model was developed for a 1-million-member commercial health plan. Monthly incident cohorts entered the model and were tracked until intracranial progression or death. Intracranial-progression probabilities were derived from METIS 12- and 24-month outcomes, with mortality assumed equivalent across arms. Costs (2025 USD) included TTFields device costs, SRS costs, intracranial-progression care, stable-disease supportive care, salvage therapies, and end-of-life care. TTFields market share increased from 5% to 25% over 5 years. The analysis compared a Without TTFields scenario (SRS + supportive care alone) with a With TTFields scenario reflecting partial adoption. Outcomes included total costs and incremental PMPM, PMPQ, and PMPY. One-way sensitivity analyses varied inputs ±25%.
RESULTS: The model projected 48 annual NSCLC brain-metastasis cases, with up to 12 TTFields-eligible patients by Year 5. In the Without TTFields scenario, 5-year spending was largely composed of intracranial-progression care ($14.7M). With TTFields, device costs totaled $2.1M and intracranial-progression costs declined to $13.7M, resulting in a net difference of $1.2M. Incremental PMPM, PMPQ, and PMPY were $0.0194, $0.0583, and $0.2330. Decreased progression-related costs partially offset device expenditures. Key sensitivity drivers were repeat SRS cost, TTFields monthly cost and duration, and progression-probability inputs.
CONCLUSIONS: TTFields adoption produces a small increase in overall payer spending, while reductions in intracranial-progression costs provide notable offsets. The resulting PMPM impact is minimal, supporting the budgetary feasibility of TTFields use for NSCLC brain metastases.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE468
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Oncology