OBJECTIVES: Adding Tumor Treating Fields (TTFields) therapy to temozolomide (TMZ) in the maintenance phase after surgery and radiochemotherapy has demonstrated an improved progression-free survival (PFS) (6.7 months median) in patients with glioblastoma (GBM) compared to TMZ only (4 months median), in the phase 3 clinical trial EF-14. This study aims to assess the cost-effectiveness of adding TTFields therapy to TMZ vs TMZ only in patients with GBM from French healthcare system perspective.

METHODS: This cost-effectiveness study was performed following the HAS methodological recommendations, with conservative requirements. A partitioned survival model was developed to compare adding TTFields therapy to TMZ only in adult patients with newly diagnosed GBM over a 20 years’ time horizon. The model used Kaplan–Meier PFS estimates, overall survival. and treatment duration from EF-14 clinical trial. All relevant direct medical costs were included. Health-related quality of life data (EQ-5D), based on an ad-hoc study conducted in the United States and Europe, were converted into health states utility values using the French tariffs.

RESULTS: Model simulations demonstrated that adding TTFields therapy to TMZ vs TMZ only in France is associated with 1.13 additional life years (LY) and 0.90 additional quality adjusted life years (QALY) as well as incremental costs of €210.2. ICERs were €186.4/LY and €232.7/QALY in the base case analysis. Main cost drivers of the results were time horizon, utility values (scenario analyses) and acquisition costs (deterministic sensitivity analysis). Compared to TMZ only, TTFields + TMZ generated savings of €1,063 in post-progression costs and savings of €301 in death costs due to greater survival in the TTFields + TMZ arm.

CONCLUSIONS: Compared to TMZ only, the strategy combining TTFields with TMZ is associated with a gain in efficiency, coming with an additional cost. This strategy was associated with sufficient added clinical value and get the national reimbursement.