OBJECTIVES: We evaluated the cost-effectiveness of tepotinib vs. alternatives considered the standard of care in Spain in previously treated patients with advanced non-small-cell lung cancer harboring METex14 skipping alterations (aNSCLC METex14) from the payer perspective.

METHODS:

A partitioned survival model was developed to represent the natural history of aNSCLC METex14 over 30 years. Three categories of comparators were set: immunotherapy (IO), chemotherapy (CT) and a distribution considered standard of care (SoC) result of the contribution of those alternatives. For tepotinib, to estimate the projected proportion of patients in each health state (progression free, progression and death) PFS and OS data from VISION study were used. For comparators, data was extracted from a real-word cohort. Utilities were derived from VISION and adverse events and age-associated disutilities were extracted from literature. Unitarian costs (€2022) were extracted from national Spanish tariffs databases and literature. A discount was applied to all notified drug costs to better determine the real cost for the Spanish Health System. Willingness to pay (WTP) threshold was set to 50.000 €. Results were expressed in quality-adjusted life-years (QALY) and incremental cost-effectiveness ratios. A probabilistic sensitivity analysis (PSA) was conducted.

RESULTS: Previously treated patients receiving tepotinib experienced an extended life expectancy of 0.65, 0.35 and 0.43 LY (Life Year) versus IO, CT and SoC. When adjusted by quality of life, total QALY gain was also higher for tepotinib compared to IO, CT and SoC (additional QALY: 0.34, 0.21 and 0.25, respectively). The ICER remained below 50.000 € for all comparisons. PSA confirmed a probability of tepotinib to be cost-effective at the WTP threshold of 88.5% vs CT and 96.5% vs IO.

CONCLUSIONS: In previously treated patients with aNSCLC METex14, tepotinib is expected to provide clinically meaningful life expectancy increase and results provide a favorable scenario for being considered cost-effective in Spain.