4CPS-070 Evaluation of avoided cost in clinical trials with immunotherapy in lung cancer

• Published in: European journal of hospital pharmacy. Science and practice 2024-03, Vol.31 (Suppl 1), p.A85-A86
• Main Authors: Escobar Hernández, L, Ballesta López, O, Megias Vericat, JE, Palanques Pastor, T, Benito Zazo, N, Mar, MM, Tordera Baviera, M, Poveda Andres, JL
• Format: Article
• Language: English
• Subjects: Clinical trials; Conflicts of interest; Costs; Economic impact; Immunotherapy; Lung cancer; Patients; Section 4: Clinical pharmacy services
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2024-eahp.174

Background and ImportanceLung cancer (LC) is the third most common prevalent cancer and the leading cause of cancer-related death. Therapeutic options for LC are limited. A large number of immunotherapy-based clinical trials (CT) are underway due to their promising results. Therefore, it is necessary to evaluate the economic impact of CT in LC patients.Aim and ObjectivesTo evaluate the economic impact of participating in CT with immunotherapy provided by the sponsor in patients with LC.Material and MethodsSingle-centre multidisciplinary study calculating the cost-saving impact of the use of immunotherapy provided by the sponsor in CT in a tertiary hospital between January2019 and December2022.Inclusion criteriapatients diagnosed with LC (small cell and non-small cell) treated with commercialised immunotherapy in CT (amivantamab, atezolizumab, avelumab, durvalumab, ipilimumab, nivolumab and pembrolizumab). Exclusion criteria: CT with placebo-masked immunotherapy.The information was retrieved from Farmis-Oncofarm®, pkEnsayos® and Orion-Logis®. Baseline characteristics (age and sex), diagnosis, clinical data (trials per phase and drug administered) and consumption data (quantity expressed in mg and costs avoided per CT, per patient and per diagnosis) were analysed.Statistical analysiscalculation of percentages and means with 95% confidence intervals (95%CI). Economic data was expressed in avoided costs.ResultsThe study included 81 patients (71.6% male) with an average age of 65.7 years (95%CI:63.8–67.6). Most of patients were diagnosed with non-small-cell LC (85.2%, n=69).A total of 27 CT were included (81.5% for non-small-cell and 18.5% for small-cell): phase I (n=1), phase I/II (n=2), phase II (n=6), phase IIa (n=1), phase III (n=12), phase IIIb (n=2), phase IIIb/IV (n=2) and phase IV (n=1). Nine of them used nivolumab (33.3%); 6 atezolizumab (22.2%); 6 pembrolizumab (22.2%); 3 durvalumab (11.1%); 2 ipilimumab (7.4%); 1 amivantamab (3.7%) and 1 avelumab (3.7%).The overall avoided cost was 2,178,167€ (1,715,360€ and 462,807€ for non-small cell lung cancer and small cell lung cancer, respectively), per CT 80,673€ and per patient 26,891€.Conclusion and RelevancePatient participation in CT with immunotherapy in LC has a great economic impact in terms of direct costs avoided in antineoplastic treatment. The inclusion of patients in these CT contributes to the sustainability of the healthcare system and allows patients access to innovative therapies.References an