WHAT IS THE CADTH REIMBURSEMENT RECOMMENDATION FOR RETEVMO?: CADTH recommends that Retevmo be reimbursed by public drug plans for the treatment of adult patients with metastatic rearranged during transfection (RET) fusion-positive non–small cell lung cancer (NSCLC), if certain conditions are met. WHICH PATIENTS ARE ELIGIBLE FOR COVERAGE? Retevmo should only be covered to treat adult patients 18 years and older with metastatic RET fusion-positive NSCLC who had never received any cancer treatment or who had prior cancer treatment. WHAT ARE THE CONDITIONS FOR REIMBURSEMENT? Retevmo should only be reimbursed if prescribed by a clinician with expertise in the management of NSCLC and if the cost of Retevmo is reduced. Retevmo should not be given or reimbursed in combination with cancer treatment. WHY DID CADTH MAKE THIS RECOMMENDATION? Evidence from a clinical trial demonstrated that people with metastatic RET fusion-positive NSCLC treated with Retevmo experienced tumour shrinkage or the tumour completely disappeared. As well, evidence from the clinical trial demonstrated brain tumour shrinkage in people whose metastatic NSCLC had spread to the brain. Based on CADTH’s assessment of the health economic evidence, Retevmo does not represent good value to the health care system at the public list price. A reduction in price is therefore required. Over 3 years Retevmo is expected to increase drug costs to the public drug plans by $10,745,897 though this is highly uncertain and could exceed $40 million.

ADDITIONAL INFORMATION

WHAT IS RET FUSION-POSITIVE NSCLC? NSCLC is a type of lung cancer originating from specific lung cell tissues which may include squamous, adenocarcinomas, or large cell type carcinomas. People with lung cancer whose cancer cells have spread to other parts of the body, such as the bones, adrenal glands, brain, and liver likely have metastatic cancer. Metastatic NSCLC can be driven by a gene in the body such the RET gene. The RET gene is present naturally in the body, but some cancers form due to changes in the RET gene. UNMET NEEDS IN RET FUSION-POSITIVE NSCLC: Patients with RET fusion-positive NSCLC are treated with chemotherapy and immunotherapy, however not all patients respond to these available treatments. HOW MUCH DOES RETEVMO COST? Treatment with Retevmo is estimated to cost $11,172 to $14,896 per 28 days if given 120 mg to 160 mg orally twice daily depending on whether the patient’s weight exceeds 50 kg.