OBJECTIVES: Lung cancer remains the commonest cause of death from cancer worldwide, posing a high disease and economic burden on healthcare systems globally. Non-Small Cell Lung Cancer (NSCLC) accounts for approximately 85% of all lung cancer cases. Immune checkpoint inhibitors, such as Atezolizumab a PD-L1 checkpoint inhibitor, offer effective treatment options for NSCLC patients. The objective of this analysis was to perform a cost-effectiveness analysis of Atezolizumab versus Docetaxel for 2nd line treatment of NSCLC patients, after prior chemotherapy, in Greece.

METHODS: A three state partitioned survival model (health states) was developed for the cost-effectiveness analysis of Atezolizumab vs Docetaxel. The model was populated with clinical effectiveness data from the literature and Greek-specific data on health resource use and costs collected from an expert panel of 10 oncologists. This analysis did not account for discounts/rebates. The analysis followed a third party payer perspective (Greek Social Insurance).

RESULTS: Atezolizumab compared to Docetaxel was accompanied by gains of 0,88 total life years (LY) per patient (2,00 vs 1,20) and a gain in Quality Adjusted Life Expectancy of 0,65 QALY’s (1,38 vs 0,73). An additional cost of €65,292 (€86.900 vs €21.608) is introduced with Atezolizumab compared to Docetaxel per patient, resulting in an ICER of 74.028/LY gained and 99.845/ QALY gained. The results are sensitive to the price of the intervention, the discount rate and the cost of the concomitant supportive care.

CONCLUSIONS: Immunotherapies are valuable in the treatment of NSCLC. This analysis suggests that Atezolizumab offers significant gains in LY and QALY’s compared to Docetaxel in the setting of Greece at a reasonable cost. For the complete understanding of the real-world outcomes of the anti-PD-L1 immunotherapy further research is required.