WHAT IS THE CADTH REIMBURSEMENT RECOMMENDATION FOR LIBTAYO?: CADTH recommends that Libtayo in combination with platinum-based chemotherapy be reimbursed by public drug plans for the first-line treatment of adults with non–small cell lung cancer (NSCLC) whose tumours have no EGFR, , or aberrations and is locally advanced where patients are not candidates for surgical resection or definitive chemoradiation, or for those with metastatic NSCLC, if certain conditions are met. WHICH PATIENTS ARE ELIGIBLE FOR COVERAGE? Libtayo in combination with platinum-based chemotherapy should only be covered to treat adults who have stage IIIB or IIIC NSCLC and are not suitable for curative surgery or definitive chemoradiation or have stage IV NSCLC and have not received prior systemic treatment. Patients’ tumours should have no EGFR, , or aberrations. Patients should have a good performance status. WHAT ARE THE CONDITIONS FOR REIMBURSEMENT? Libtayo should only be reimbursed in combination with platinum-based chemotherapy if prescribed by clinicians with expertise and experience in treating NSCLC. The treatment should be delivered in outpatient specialized oncology clinics with expertise in systemic therapy delivery and management of immunotherapy-related side effects. The price of Libtayo should be negotiated so that its use in combination with platinum-based chemotherapy does not exceed the total drug cost of treatment with the least costly immunotherapy reimbursed in the first-line setting. WHY DID CADTH MAKE THIS RECOMMENDATION? Evidence from a clinical trial demonstrated that treatment with Libtayo in combination with platinum-based chemotherapy was better than treatment with platinum-based chemotherapy alone in allowing patients to live longer and delaying cancer progression. Libtayo meets patient needs of delaying disease progression, prolonging survival, and offering an additional treatment option. Based on CADTH’s assessment of the health economic evidence, Libtayo does not represent good value to the health care system at the public list price. The committee determined that there is not enough evidence to justify a greater cost for Libtayo in combination with platinum-based chemotherapy compared with pembrolizumab or nivolumab and ipilimumab in combination of platinum-based chemotherapy over the duration of treatment. Based on public list prices, Libtayo in combination with platinum-based chemotherapy is estimated to cost the public drug plans approximately $5 million over the next 3 years.
WHAT IS NSCLC? NSCLC occurs when healthy cells in the lung become cancerous and is considered metastatic when cancer cells have spread to other parts of the body. NSCLC is the most common type of lung cancer, comprising about 80% of all lung cancer cases. Approximately 30,000 new cases of NSCLC are diagnosed each year in Canada. UNMET NEEDS IN NSCLC: Not all patients have a response to currently available treatments for advanced NSCLC and most patients will experience disease progression. HOW MUCH DOES LIBTAYO COST? Treatment with Libtayo in combination with platinum-based chemotherapy is expected to cost between $9,055 and $13,735 per 21-day course, depending on the chemotherapy combination of choice.
