"Cost-Effectiveness Analysis of 240 mg Sotorasib for KRAS-G12C Mutated " by Drew Bailey, PharmD
 

Cost-Effectiveness Analysis of 240 mg Sotorasib for KRAS-G12C Mutated Non-Small Cell Lung Cancer: A Payer Perspective in the US Market

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Presentation

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Publication Date

11-13-2024

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Presentation: 23:54

Abstract

Sotorasib is a recently approved targeted therapy for KRAS G12C-mutated non-small-cell lung cancer (NSCLC). Initially approved at a 960 mg dose, recent studies suggest a lower 240 mg dose may provide similar efficacy at reduced costs. This study evaluated the cost-effectiveness of 240 mg versus 960 mg of sotorasib from a U.S. payer perspective to inform potential dose optimization strategies. A partitioned survival model was constructed using data from Hochmair et al. and cost inputs from meta-analysis and systematic reviews and UptoDate. Key health states included progression-free survival, progressed disease, and death, with a 60-month time horizon and a 3% discount rate. Gompertz models were used to extrapolate survival beyond observed data. The base-case analysis yielded an incremental cost-effectiveness ratio (ICER) of $169,107 per quality-adjusted life year (QALY), slightly above the willingness-to-pay threshold of $150,000 per QALY. Sensitivity analyses with ±20% variations in cost and utilities produced ICERs ranging from $25,078 to $211,383. The AIC values suggested a better fit for the Gompertz model at the 240 mg dose, indicating consistent survival trends with lower dosing. Limitations included using different utility sources for progression-free and progressed states and reliance on digitized survival data. Overall, 240 mg sotorasib may offer a cost-effective alternative for managing KRAS G12C-mutated NSCLC, supporting the potential for dose optimization in line with FDA initiatives. Further studies are needed to validate these findings in real-world settings.

Language

English

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