OBJECTIVES

To estimate inpatient costs associated with serious adverse events (SAEs) secondary to neurotrophic receptor tyrosine kinase (NTRK) inhibitor therapies (larotrectinib and entrectinib) in unresectable or metastatic solid tumor patients

METHODS

An economic analysis was conducted utilizing two sources of data: NTRK inhibitor (ie, larotrectinib and entrectinib) Prescribing Information (PI) from which SAE (Grade 3 or 4) rates were captured, and 2016 Healthcare Utilization Project Nationwide Inpatient Sample data from which SAE inpatient costs were identified. SAE rates listed in PI adverse event (AE) tables, Warnings and Precautions sections, and other PI sections were multiplied by cost data in order to determine incidence-adjusted SAE costs. Costs were stratified by low incidence (occurring in <10% of patients) and high incidence SAEs (occurring in ≥10% of patients).

RESULTS

Fifty seven SAEs were included. The sum of incidence-adjusted costs per SAE equaled $3,068 and $6,682 for larotrectinib and entrectinib, respectively (P=0.003). Larotrectinib was associated with a cumulative incidence-adjusted SAE cost savings of $3,614 per patient when compared with entrectinib. When stratified by low and high incidence SAE groups, larotrectinib compared to entrectinib was cost saving ($1,597 and $2,017 saved per patient, respectively).

CONCLUSIONS

Larotrectinib demonstrates a less economically burdensome SAE profile compared to entrectinib in the treatment of unresectable or metastatic solid tumors. Future real-world analyses should be conducted in order to better characterize AE-related economic burden, including that related to less severe AEs and AE-related medical expenditures not captured within inpatient datasets.