OBJECTIVES: Adjuvant treatment with osimertinib significantly improves disease-free survival in patients with completely resected early-stage (IB-IIIA) EGFRm non-small cell lung cancer (NSCLC) compared with placebo, but the impact of osimertinib on societal economic costs is unknown. Here, we estimate the societal savings resulting from the use of adjuvant osimertinib vs. placebo in early-stage (IB-IIIA) EGFRm NSCLC in a United Kingdom (UK) setting.

METHODS: A semi-Markov, multi-state transition model estimated the impact of osimertinib on the societal costs of labor, transportation, informal care, sick leave benefits, and disability pension among a population of employed patients with NSCLC (N=287, derived using epidemiological data). Cost inputs, demographic and epidemiological data, and employment rates were primarily from the Office of National Statistics website and osimertinib disease-free survival data were from the ADAURA clinical trial [NCT02511106]. Where UK-specific sources were unavailable, relevant peer-reviewed articles and publicly available health technology assessments were used. The time horizon was 13 years, based on a median age of 62 years and maximum of 75 years. A 1.5% discounting rate was applied and a one-way sensitivity analysis (OWSA) was conducted.

RESULTS: Total incremental societal savings were approximately £2.5 million with adjuvant osimertinib, amounting to £19,222 in per-patient societal savings. Work productivity was the highest contributor, followed by informal care and transportation costs. Adjuvant osimertinib treatment corresponded to a 24.2% increase in return to work. The OWSA showed the most sensitive parameters to change were the maximum working age, proportion of patients in the disease-free state returning to work, and number of patients eligible for adjuvant therapy with osimertinib.

CONCLUSIONS: Adjuvant osimertinib resulted in substantial societal savings vs. placebo in the treatment of early-stage (IB-IIIA) EGFRm NSCLC, due primarily to the increased proportion of disease-free patients leading to greater productivity.