OBJECTIVES: Tepotinib, an oral, once-daily and highly selective MET inhibitor, is MHRA-approved and NICE-recommended for the treatment of METex14 skipping advanced NSCLC (aNSCLC). This budget impact analysis evaluated the economic impact to NHS England of introducing tepotinib as a treatment for patients with METex14 skipping aNSCLC.

METHODS: A budget impact model was developed to compare the costs associated with standard-of-care chemotherapy and immunotherapy treatments in aNSCLC without driver mutations with the costs of introducing tepotinib to the treatment paradigm, over a 5-year time horizon. The yearly eligible population was estimated using the number of new aNSCLC patients per year in England and the estimated prevalence of METex14 skipping in NSCLC. Costs included drug list prices, drug administration costs, and oncogene testing costs (based on published sources and assumptions). The cost-per-treatment course was calculated using mean/median treatment durations from clinical trials. Product licenses and NICE recommendations informed treatment dosing information, and market shares were based on assumptions and clinical expert opinion.

RESULTS: Approximately 756 patients per year are eligible for treatment with tepotinib in England. Introducing tepotinib into the treatment paradigm is estimated to cost NHS England £7.1m in Year 1, increasing to £12.1m by Year 5, for a total of £47.9m over 5 years, assuming list prices. However, replacing chemotherapy and immunotherapy infusions with tepotinib is estimated to reduce administration costs for the NHS by £5.9m over 5 years.

CONCLUSIONS: The budget impact of tepotinib in England is expected to be substantially below the 3-year £20m threshold set by NICE, assuming list prices, and lower when accounting for confidential discounts of tepotinib and comparators. Tepotinib is the first and currently only NICE-recommended targeted treatment option for patients with METex14 skipping aNSCLC.