PCN76 - BUDGET IMPACT ANALYSIS OF AFATINIB FOR THE FIRST-LINE TREATMENT OF ADVANCED OR METASTATIC NON–SMALL-CELL LUNG CANCER IN CHINA

Abstract

Afatinib is approved in China for the first-line treatment of patients with advanced or metastatic non–small-cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) mutations. The objective of this study is to evaluate the budget impact of adding afatinib to the National Reimbursement Drug List (NRDL) covered by basic health insurance (BHI) in China. A simple model was developed to evaluate the budget impact over a 5-year time horizon. The number of patients eligible for treatment was estimated using published incidence data. Therapies included in the model were afatinib, erlotinib, gefitinib (including a generic drug), and icotinib. Drug-acquisition costs were retail price or reimbursement payment standard. Market share of tyrosine kinase inhibitors (TKIs) was estimated by market-research data. The mean time for patients using TKIs was assumed to be 11 months, based on progression-free survival data from clinical trials. Using the base-case parameter assumptions, the total budget would increase by ¥79 million, ¥147 million, ¥172 million, ¥169 million, and ¥152 million in the first 5 years of afatinib on NRDL. This translates into small increases in the per-patient-per-year (PPPY) cost of ¥757, ¥1,255, ¥1,430, ¥1,363, and ¥1,188; and increases in the per-member-per-year (PMPY) costs of ¥0.06, ¥0.11, ¥0.13, ¥0.13, and ¥0.11 in years 1 through 5, respectively. Afatinib is likely to have a marginal impact on the BHI budget in China. Considering that afatinib is the only drug that has demonstrated improvement in overall survival versus chemotherapy in the del19 population and has shown superiority in progression-free survival versus gefitinib in this setting, afatinib is a budget-neutral way of improving cancer care for patients with EGFR+ NSCLC in China. Further analysis needs to consider progression-free and overall survival times of patients, costs of managing adverse reactions, and additional disease management costs.