OBJECTIVES

To conduct an economic analysis comparing the costs of managing adverse events (AEs) and treatment administration in patients with relapsed small cell lung cancer (SCLC) treated either with lurbinectedin or intravenous (IV) topotecan.

METHODS

: A cost analysis was conducted comparing the costs of managing Grade ≥3 AEs and treatment administration with lurbinectedin and topotecan. The incidence of AEs was obtained from the Basket trial for lurbinectedin (n=105) and from three randomised controlled trials (RCTs) for topotecan (1.5mg/m²/day): Von Pawel 1999 (n=107), Von Pawel 2001 (n=54) and Eckardt 2007 (n=151). Trials were identified via targeted literature review; RCTs permitting granulocyte-colony stimulating factor and/or antibiotic as primary prophylaxis were excluded. AEs affecting >1% of patients in either treatment were included in the analysis and the time horizon was in line with median treatment duration (4 cycles). Where AEs were reported as percentage of cycles (this was the case for febrile neutropenia in von Pawel 2001 and Eckardt 2007) they were converted to percentage of patients. Spanish and UK costs were obtained from the literature and local costs databases.

RESULTS

: In the UK and Spain, the mean total costs per patient were higher for topotecan than lurbinectedin. In Spain, mean total costs: lurbinectedin = €3,042 and topotecan = €11,447 (range: €11,155- €11,727). In UK, mean total costs: Lurbinectedin = £3,973 and topotecan = £14,383 (range: £13,697 - £15,271). This resulted in a total cost saving of €8,406 in Spain and £10,409 in the UK for lurbinectedin vs topotecan. Spain disaggregated results showed a cost saving of €5,103 and €3,302 for administration and AEs, respectively. UK disaggregated results showed a cost saving of £4,629 and £5,780 for administration and AEs, respectively.

CONCLUSIONS

: Lurbinectedin demonstrated consistent cost savings in terms of both treatment administration and management of AEs in Spain and the UK.