OBJECTIVES: To evaluate the budget impact of introducing larotrectinib for ΝTRK gene fusion positive solid tumors and assess the affordability of this therapy for the Greek public healthcare system over a 5-year time horizon.

METHODS: The model considers the Greek National Healthcare Payer perspective and as such, only direct costs were included. Model inputs include epidemiology data, testing rate predictions from Key Opinion Leaders (KOLs) survey, larotrectinib current and future market share projections, treatment and administration costs; data as per current reimbursed prices per unit. The model considers tumor types with either high frequency of NTRK gene fusion or high prevalence in the Greek population. The efficacy inputs are based on results of the clinical program of larotrectinib.

RESULTS: Over a 5-year time horizon, the budgetary impact results in a €3m increase in total costs when larotrectinib is added as a treatment. The increase in budget is primarily driven by NSCLC, thyroid, and colon cancers, as these three tumor types have the highest incidence rates and subsequently the higher number of patients eligible for larotrectinib treatment. Moreover, introduction of larotrectinib results in a 55,580€ decrease in administration costs over the 5year time horizon.

CONCLUSIONS: Beyond the clinical value of larotrectinib that provides significant and targeted clinical benefit to 8 out of 10 patients with TRK fusion cancer regardless of tumor type and age, the budget impact analysis indicates that larotrectinib is associated with a manageable budget increase with reduction in administration costs. This makes it a value-based investment for payers that can transform patient lives without a substantial impact on resource utilisation due to the low incidence of TRK fusion cancer.