WHAT IS THE CADTH REIMBURSEMENT RECOMMENDATION FOR RETEVMO?: CADTH recommends that Retevmo be reimbursed by public drug plans for the treatment of adults with advanced or metastatic rearranged during transfection () fusion-positive differentiated thyroid cancer (DTC) if certain conditions are met. WHICH PATIENTS ARE ELIGIBLE FOR COVERAGE? Retevmo should only be covered to treat patients who have advanced or metastatic DTC (not amenable to surgery or radioactive iodine therapy) with the mutation and have had prior treatment with sorafenib and/or lenvatinib. Patients receiving Retevmo should be in relatively good health (i.e., have a good performance status, as determined by a specialist). WHAT ARE THE CONDITIONS FOR REIMBURSEMENT? Retevmo should only be reimbursed if it is prescribed by a specialist, the patients' cancer is positive, it is not given in combination with other anticancer drugs, and the price is reduced. WHY DID CADTH MAKE THIS RECOMMENDATION? Evidence from a clinical trial demonstrated tumour shrinkage in people with fusion-positive DTC treated with Retevmo. Retevmo may meet important patient-identified needs (i.e., another oral treatment option and potential to prolong survival). Retevmo is not considered cost-effective compared to best supportive care (BSC). Economic evidence suggests that a reduction in price of at least 89% would be needed for Retevmo to be considered cost-effective at a willingness-to-pay threshold of $50,000 per quality-adjusted life-year (QALY) in the indicated population. Based on public list prices, Retevmo will cost the public drug plans $4,845,673 over 3 years. The estimates of cost-effectiveness and price reduction are highly uncertain due to the quality of the evidence.
WHAT IS DIFFERENTIATED THYROID CANCER? When cancer cells resemble healthy cells to some degree, it is called a “differentiated” cancer. Thyroid cancer is cancer that initiates in the thyroid gland. The most common types of thyroid cancer are papillary and follicular. People with thyroid cancer whose cancer cells have spread to other parts of the body, such as the lung or bones, likely have advanced or metastatic cancer. UNMET NEEDS IN DIFFERENTIATED THYROID CANCER: Patients with advanced or metastatic DTC have few treatment options available in Canada and not all respond to these treatments. HOW MUCH DOES RETEVMO COST? Treatment with Retevmo is expected to cost between $11,172 and $14,896 per 28-day cycle, depending on patient weight.
