OBJECTIVES: Early-stage non-small cell lung cancer (eNSCLC) recurrences lead to a substantial increase in healthcare costs and resource utilization. Based on IMpower010 trial, atezolizumab (ATZ) has been recently approved by the EMA as adjuvant treatment following resection and platinum-based chemotherapy for stage II-IIIA NSCLC patients with PD-L1 expression ≥50%. This analysis aimed to estimate the economic impact of prevented recurrences by measuring the avoided costs in the Italian population potentially eligible for adjuvant ATZ.

METHODS: An epidemiological analysis was developed using a published model, adapted to the Italian context, to estimate the number of recurrences per year from 2023 to 2033, comparing the scenario “with ATZ” vs “without ATZ”. Epidemiological and clinical input were obtained from published literature, clinical trials, and local market research. Direct healthcare costs were sourced from an Italian real-world study. The National Health System perspective was considered and a deterministic One-way Sensitivity Analysis (OWSA) was performed to evaluate the uncertainty over the main parameters.

RESULTS: Over the period considered, 2582 eNSCLC patients with stage II-IIIA after resection and chemotherapy were estimated annually. Of these, 720 patients (27.9%) were potentially eligible to receive ATZ according to the approved indication. Overall, the model estimated for the eligible patients 2556 recurrences that generated an economic burden of 11.02 M€ yearly. ATZ introduction could reduce a total of 720 recurrences (111 locoregional and 609 metastatic) resulting in a direct healthcare cost reduction of -3,11 M€ yearly from the Italian NHS perspective. OWSA showed moderate base case changes especially due to drug cost in metastatic setting.

CONCLUSIONS: Recurrences are common among eNSCLC patients and are associated with a remarkable increase in total direct cost. Adjuvant ATZ seems to prevent a relevant number of events with potential savings in recurrence-related costs from the NHS perspective in Italy.