Cost-effectiveness of sotorasib as a second-line treatment for non-small cell lung cancer with KRASG12C mutation in China and the US.

Abstract

e20567 Background: Sotorasib was used for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer with KRASG12Cmutation who had received at least one systematic therapy, showing good antitumor activity and safety. However, it was unclear whether the high-cost sotorasib was cost-effective. Methods: A Markov model was developed to compare the lifetime cost and efficacy of sotorasib to treat non-small cell lung cancer with KRASG12C mutation from the CodeBreak 200 randomized placebo-controlled trial, which included 345 patients with previously treated non-small cell lung cancer with KRASG12C mutation. Incremental cost-effectiveness ratio(ICER), quality-adjusted life-year (QALY), incremental QALY were calculated for the 2 treatment strategies. One-way sensitivity analysis was used to investigate the factors that had a greater impact on the model results, and tornado diagram was used to verify the model stability, probabilistic sensitivity analysis was performed by Monte Carlo simulation, random factors were introduced into the model to simulate a certain number of large samples, and the results were presented as cost-effectiveness acceptable curves. Results: This economic evaluation of data from the CodeBreak 200 randomized trial. In China, sotorasib generated 0.44 QAYL with a total cost of $84372.59. Compwered with docetaxel, the ICER value of sotorasib was $102701.84/QALY, which was higher than WTP, so sotorasib had no economic advantage. In the US, sotorasib obtained 0.35 QALY more than docetaxel, ICER was $15,976.50 /QALY, which was low than WTP, indicating that the increased cost of sotorasib was acceptable. Conclusions: Sotorasib had cost effect from the perspective of the US. Howere, sotorasib had no cost effect from the perspective of China, and only when the willingness to pay(WTP) exceeds $102,500, the probability of sotorasib having cost effect increases from 0 to 49%.