PCN164 THE BUDGET IMPACT OF TTFIELDS + PLATINUM-BASED THERAPY FOR FIRST-LINE MESOTHELIOMA TREATMENT

Abstract

A budget impact model was created to estimate the financial impact to a payer when introducing TTFields in combination with pemetrexed and a platinum agent to the formulary for malignant pleural mesothelioma (MPM). The budget impact model compared a pre-approval scenario to a post-approval scenario over a five-year time horizon for a theoretical plan containing two million lives in the United States. The model assumed a first-line treatment rate of 70% for MPM. Available first-line treatments included pemetrexed + cisplatin, pemetrexed + cisplatin/carboplatin + bevacizumab, pemetrexed monotherapy, gemcitabine + platin, gemcitabine monotherapy, and vinorelbine monotherapy. The market share of TTfields + pemetrexed + cisplatin/carboplatin was assumed to rise linearly from 9% in year one to 22.5% in year five. The market share gain for TTFields was proportionally subtracted from all other available first-line therapeutic regimens. The model considered overall survival and adverse events based on clinical trial data. Dosing assumptions were based on clinical trial data, NCCN guidelines, and package inserts. Subsequent therapy was considered for 30% of eligible patients. Costs included drug/device, administration, adverse event, and subsequent therapy. All costs are presented in 2019 USD and sourced from Medicare and Novocure. Costs were discounted at 3%. The forecasted budget impact of introducing TTFields + pemetrexed + cisplatin/carboplatin was $374,104 (per member per month (PMPM) = $0.003) over the five-year time horizon. The increase in budget was driven by higher drug and device costs of $370,593 (PMPM = $0.003) and subsequent therapy costs of $55,224 (PMPM = $0.0005). Drug administration and adverse event costs were reduced by $4,641 (PMPM = $0.00004) and $47,073 (PMPM = $0.0004), respectively. The introduction of TTFields to the formulary of a theoretical two million patient health plan resulted in a small overall and PMPM increase in the budget.