Costs Associated With the Administration, Postinfusion Monitoring, and Management of Adverse Events (AEs) Related to Novel Drugs for Second-Line (2L+) Treatment of Small-Cell Lung Cancer (SCLC)
Author(s)
Jesús Gullón Sanz, BSc, MSc, Inés Pérez Román, PhD.
Pharmamar, Madrid, Spain.
Pharmamar, Madrid, Spain.
OBJECTIVES: To compare the costs of administration, post-infusion monitoring, and management of AEs of lurbinectedin and tarlatamab for 2L treatment of SCLC patients.
METHODS: A literature review identified trials evaluating lurbinectedin or tarlatamab in 2L SCLC. The phase 2 Basket trial (lurbinectedin) and the phase 3 DeLLphi‑304 trial (tarlatamab) were selected. Data on treatment and cycle duration, frequency of administration, duration and nature of post-infusion monitoring, and incidence of AEs were sourced from the respective trials. Adverse events of any grade reported in ≥10% of the patients were included in the analysis. Adverse event costs were stratified by level of severity. As this analysis focused on the United Kingdom, the unit costs were sourced from the 2023/24 National Cost Collection data of the National Health Service (NHS) in England, and from the 2024 Unit Costs of Health and Social Care Manual published by the Personal Social Services Research Unit (PSSRU).
RESULTS: Tarlatamab requires more frequent administrations than lurbinectedin (every 2 weeks vs. every 3 weeks) and was associated with prolonged hospital stays following initial infusions. This resulted in approximately a five-fold increase in the administration and post-infusion costs compared to lurbinectedin. The most frequently reported AEs were cytokine release syndrome (CRS) and decreased appetite for tarlatamab and anemia and creatinine alterations for lurbinectedin. Treatment with tarlatamab resulted in a ~34%-cost increase in the management of AEs compared to lurbinectedin. The increased costs were driven by the management of the CRS and gastrointestinal symptoms. When combining administration, post-infusion monitoring, and AE management costs, treatment with tarlatamab was more than twice as expensive as with lurbinectedin.
CONCLUSIONS: This analysis showed that treatment with lurbinectedin is associated with substantial cost savings in the administration, post-infusion monitoring, and adverse events management compared with tarlatamab in 2L SCLC.
METHODS: A literature review identified trials evaluating lurbinectedin or tarlatamab in 2L SCLC. The phase 2 Basket trial (lurbinectedin) and the phase 3 DeLLphi‑304 trial (tarlatamab) were selected. Data on treatment and cycle duration, frequency of administration, duration and nature of post-infusion monitoring, and incidence of AEs were sourced from the respective trials. Adverse events of any grade reported in ≥10% of the patients were included in the analysis. Adverse event costs were stratified by level of severity. As this analysis focused on the United Kingdom, the unit costs were sourced from the 2023/24 National Cost Collection data of the National Health Service (NHS) in England, and from the 2024 Unit Costs of Health and Social Care Manual published by the Personal Social Services Research Unit (PSSRU).
RESULTS: Tarlatamab requires more frequent administrations than lurbinectedin (every 2 weeks vs. every 3 weeks) and was associated with prolonged hospital stays following initial infusions. This resulted in approximately a five-fold increase in the administration and post-infusion costs compared to lurbinectedin. The most frequently reported AEs were cytokine release syndrome (CRS) and decreased appetite for tarlatamab and anemia and creatinine alterations for lurbinectedin. Treatment with tarlatamab resulted in a ~34%-cost increase in the management of AEs compared to lurbinectedin. The increased costs were driven by the management of the CRS and gastrointestinal symptoms. When combining administration, post-infusion monitoring, and AE management costs, treatment with tarlatamab was more than twice as expensive as with lurbinectedin.
CONCLUSIONS: This analysis showed that treatment with lurbinectedin is associated with substantial cost savings in the administration, post-infusion monitoring, and adverse events management compared with tarlatamab in 2L SCLC.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE289
Topic
Economic Evaluation, Health Technology Assessment, Medical Technologies
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Trial-Based Economic Evaluation
Disease
Oncology, Rare & Orphan Diseases, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)