OBJECTIVES: Lung cancer is the main cause of cancer related deaths worldwide, with non-small cell lung cancer (NSCLC) representing approximately 85% of all cases. Nearly 30-40% of NSCLC patients have metastatic disease at diagnosis (mNSCLC). Five-year survival rates for mNSCLC are below 36%. This study aimed to assess the cost-effectiveness of nintedanib for the treatment of adult patients with locally advanced, metastatic or locally recurrent NSCLC of adenocarcinoma tumour histology after first-line chemotherapy in Portugal.

METHODS: A survival model was developed to represent the natural history of NSCLC for a lifetime horizon. Best supportive care (BSC) + docetaxel were set as the comparator. Efficacy and safety were derived from a phase III, randomised, double-blinded clinical trial (LUME-Lung 1) which compared nintedanib+docetaxel to placebo+docetaxel. Parametric survival analyses were performed and best fitting survival function was selected using Akaike's Information Criterion. Costs were derived from public sources. A 5% annual discount rate was adopted for costs and effects. Results were expressed in incremental costs per life year (LY) and quality-adjusted life years (QALY).

RESULTS: On average, nintedanib + docetaxel is expected to increase mNSCLC undiscounted life expectancy by 0.39 LYs versus BSC + docetaxel (21.7 versus CONCLUSIONS: In the 2nd mNSCLC line setting, nintedanib is expected to provide a clinically meaningful life expectancy increase at an incremental cost per life year gained within an acceptable range.