OBJECTIVES: Lung cancer is the leading cause of cancer mortality in Brazil. Durvalumab has drastically improved clinical outcomes for patients with stage III non-small cell lung cancer (NSCLC) after chemoradiation with a reduction of 41% and 45% in the risk of metastasis and disease progression, respectively. This research aims to estimate the potential saving in NSCLC stage IV after durvalumab treatment in the Brazilian private healthcare system.

METHODS: A Markov budget impact model with three health states - progression-free survival, progressive disease, and death - was built, considering a 5-year time horizon. For stage IV treatment, chemotherapy, target therapies and immunotherapies were considered. Only medical direct treatment costs were counted, from a healthcare payer perspective. Drug acquisition costs were extracted from the list price regulated by Câmara de Regulação do Mercado de Medicamentos (CMED); tests and procedures costs were extracted from private healthcare standard tables (CBHPM and Planserv). Epidemiological data were obtained from published medical literature on stage III NSCLC. The market share was assumed 50% in year-1 and rising over time to 100% in year- 5.

RESULTS: In 5 years, the total eligible population was 928 patients. This data was measured through an epidemiological funnel with literature data and Brazilian population growth over the 5 years. Treatment with durvalumab led to a reduction in the number (N=132) of individuals who progressed to stage IV and remained in stage III. The model yielded an average saving of BRL 729,618.22 in the stage IV treatment per patient. The total budget saving was BRL 36,580,807.54 over the 5-years.

CONCLUSIONS: The use of durvalumab as consolidation therapy in stage III disease could lead to substantial saving for NSCLC treatment. The saving was mainly driven by the decrease in the number of individuals in stage IV as well as the reduction of costs associated with progressive and death.