ESTIMATED VALUE OF OPTIMIZED TUMOR TREATING FIELDS DELIVERY IN NEWLY DIAGNOSED GLIOBLASTOMA: AN EXPLORATORY COST-UTILITY ANALYSIS
Author(s)
Jorge F. Nino de Rivera Guzman, MSc1, Bruce Wang, PhD2.
1Health Economy specialist, Novocure, Glendale, CO, USA, 2Elysia Group, LLC, New York, NY, USA.
1Health Economy specialist, Novocure, Glendale, CO, USA, 2Elysia Group, LLC, New York, NY, USA.
OBJECTIVES: TTFields improve survival in newly diagnosed glioblastoma (ndGBM); evidence suggests outcomes are sensitive to the quality of TTFields delivery at the tumor. An optimized array placement program designed to maximize delivery quality at the individual level may advance treatment outcomes. This analysis estimates the added value of optimized TTFields delivery over suboptimal in terms of LYs, QALYs, costs, and ICERs.
METHODS: Three separate cost-utility analyses were conducted using a partitioned survival model to estimate LYs, QALYs, and costs for TTFields-treated ndGBM patients from a US payer perspective. Survival relationships were derived from a simulation-based analysis of 340 EF-14 patients; costs and utilities were sourced from published US GBM economic literature. Each analysis evaluated a distinct TTFields delivery quality metric: local minimum field intensity (LMiFI ≥1.06 V/cm), local minimum power density (LMiPD ≥1.15 mW/cm³), and local minimum dose density (LMiDD ≥0.77 mW/cm³). For each metric, adjusted hazard ratios for patients above each threshold and their inverses for patients below were applied as high and low delivery quality scenario inputs, respectively, assuming proportional symmetry given the absence of directly observed low-delivery quality survival data.
RESULTS: Across all three metrics, optimized TTFields delivery was associated with gains in LYs and QALYs at incremental cost, resulting in highly favorable ICERs. For LMiFI, optimized delivery resulted in 1.83 additional LYs and 1.43 additional QALYs at an incremental cost of $15,513, corresponding to an ICER of $10,842/QALY. For LMiPD, gains were 2.01 LYs and 1.56 QALYs at an incremental cost of $18,488 (ICER $11,818/QALY). For LMiDD, gains were 1.84 LYs and 1.47 QALYs at an incremental cost of $12,947 (ICER $8,822/QALY).
CONCLUSIONS: Optimized TTFields delivery quality is associated with substantial survival gains and favorable cost-effectiveness versus suboptimal delivery. LMiDD, which combines power density and device compliance, yielded the strongest result, suggesting that optimizing the full delivery drives greater value.
METHODS: Three separate cost-utility analyses were conducted using a partitioned survival model to estimate LYs, QALYs, and costs for TTFields-treated ndGBM patients from a US payer perspective. Survival relationships were derived from a simulation-based analysis of 340 EF-14 patients; costs and utilities were sourced from published US GBM economic literature. Each analysis evaluated a distinct TTFields delivery quality metric: local minimum field intensity (LMiFI ≥1.06 V/cm), local minimum power density (LMiPD ≥1.15 mW/cm³), and local minimum dose density (LMiDD ≥0.77 mW/cm³). For each metric, adjusted hazard ratios for patients above each threshold and their inverses for patients below were applied as high and low delivery quality scenario inputs, respectively, assuming proportional symmetry given the absence of directly observed low-delivery quality survival data.
RESULTS: Across all three metrics, optimized TTFields delivery was associated with gains in LYs and QALYs at incremental cost, resulting in highly favorable ICERs. For LMiFI, optimized delivery resulted in 1.83 additional LYs and 1.43 additional QALYs at an incremental cost of $15,513, corresponding to an ICER of $10,842/QALY. For LMiPD, gains were 2.01 LYs and 1.56 QALYs at an incremental cost of $18,488 (ICER $11,818/QALY). For LMiDD, gains were 1.84 LYs and 1.47 QALYs at an incremental cost of $12,947 (ICER $8,822/QALY).
CONCLUSIONS: Optimized TTFields delivery quality is associated with substantial survival gains and favorable cost-effectiveness versus suboptimal delivery. LMiDD, which combines power density and device compliance, yielded the strongest result, suggesting that optimizing the full delivery drives greater value.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE530
Topic
Economic Evaluation
Disease
Oncology