WHAT IS THE CADTH REIMBURSEMENT RECOMMENDATION FOR TECENTRIQ?: CADTH recommends that Tecentriq, in combination with a platinum-based chemotherapy and etoposide, should be reimbursed by public drug plans for the treatment of extensive-stage small cell lung cancer (ES-SCLC) if certain conditions are met. WHICH PATIENTS ARE ELIGIBLE FOR COVERAGE? Tecentriq should only be covered to treat adult patients who have not received previous treatment for ES-SCLC and who are in relatively good health. WHAT ARE THE CONDITIONS FOR REIMBURSEMENT? Tecentriq should only be reimbursed when used in combination with platinum-based chemotherapy and etoposide if it is prescribed and patients are monitored by clinicians with expertise in managing ES-SCLC, and if the price of Tecentriq leads to cost savings for the public drug plans. WHY DID CADTH MAKE THIS RECOMMENDATION? Evidence from a clinical trial showed that patients treated with Tecentriq in combination with platinum-based chemotherapy and etoposide, lived longer than patients treated with only platinum-based chemotherapy and etoposide. Tecentriq meets some of the needs identified by patients: it is an additional treatment option with manageable side effects, it delays disease progression, and allows patients to remain independent without compromising quality of life. Based on CADTH’s assessment of the health economic evidence, Tecentriq is anticipated to be cost saving to the health care system at the public list price. Based on public list prices, Tecentriq is estimated to save the public drug plans approximately $32 million over the next 3 years.
WHAT IS ES-SCLC? SCLC is 1 of 2 types of lung cancer; it is less common than non–small cell lung cancer, accounting for approximately 15% of patients with lung cancer. SCLC is an aggressive form of lung cancer that can spread early and quickly before it causes symptoms. Most people with SCLC are diagnosed with extensive-stage cancer that has spread widely within the lungs, lymph nodes, and other parts of the body. Less than half of patients who are diagnosed with or start treatment for ES-SCLC are expected to live beyond 1 year. UNMET NEEDS IN ES-SCLC? Although most patients with ES-SCLC respond to first-line treatment with chemotherapy, many experience a relapse within 1 year of finishing treatment. Imfinzi is another immunotherapy that is also used as a first treatment for ES-SCLC. When used in combination with platinum-based chemotherapy and etoposide, Tecentriq could be another treatment option to allow for a choice of therapy with Imfinzi. Second-line treatment options are very limited. HOW MUCH DOES TECENTRIQ COST? Treatment with Tecentriq is expected to cost approximately $9,035 per patient per 28-day cycle.
