OBJECTIVES:

This study aims to perform a budget impact analysis to quantify the economic consequences of the introduction of alectinib as a frontline therapeutic alternative in Italian patients with untreated anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC).

METHODS:

A budget impact model was developed to compare expected 1,2, and 3 years costs in a scenario that considers alectinib as a treatment option reimbursed by the Italian NHS and a scenario in which alectinib shares are redistributed among the alternatives available.

A patient flow model was adopted to measure the eligible patients that receive a therapy among the available alternatives, whilst direct medical costs per patient account for drugs, administration, central nervous system (CNS) metastasis and adverse event management. Epidemiological data and unit costs are collected from Italian published sources, when available. Patients entered gradually and consistently over the year course and receive the assigned I line therapy until carcinoma progression. Beyond, the model assumed that all patients were treated with a second treatment line.

RESULTS:

The overall 3-year population with ALK+ NSCLC was determined to be approximately 1,700 patients. The introduction of alectinib in the treatment of this neoplasm leads to an improvement in the patient's life conditions resulting in a saving of resources related to the remission of brain metastasis and associated with the reduction of complications, which partially offset the increased pharmaceutical costs. The overall impact of alectinib on a 3-year budget is estimated in approximately € 16 million.

CONCLUSIONS:

The different safety and effectiveness profiles of the available therapies indicate that the introduction of alectinib improves prognosis in the Italian NSCLC with ALK translocation population with incremental sustainable expenditure.