PMID- 35100006 OWN - NLM STAT- MEDLINE DCOM- 20220328 LR - 20220401 IS - 2376-1032 (Electronic) IS - 2376-0540 (Linking) VI - 28 IP - 4 DP - 2022 Apr TI - Budget impact analysis of trilaciclib for decreasing the incidence of chemotherapy-induced myelosuppression in patients with extensive-stage small cell lung cancer in the United States. PG - 435-448 LID - 10.18553/jmcp.2022.21379 [doi] AB - BACKGROUND: Chemotherapy-induced myelosuppression, which commonly manifests as neutropenia, anemia, and/or thrombocytopenia, is a frequent and severe complication of standard treatment regimens for patients with extensive-stage small cell lung cancer (ES-SCLC). Trilaciclib is a first-in-class myeloprotective therapy indicated to decrease the incidence of chemotherapy-induced myelosuppression when administered prior to a platinum-/etoposide-containing regimen or topotecan-containing regimen for ES-SCLC. OBJECTIVE: To estimate the budget impact of administering trilaciclib prior to chemotherapy to manage chemotherapy-induced myelosuppression in adults with ES-SCLC from a US payer perspective. METHODS: A budget impact model was developed to assess the impact of introducing trilaciclib to a hypothetical 1 million-member health insurance plan. The model compared 2 market scenarios: a current scenario of standard treatments for ES-SCLC without trilaciclib, and an alternative scenario of standard treatment plus trilaciclib. Population, clinical, and cost inputs were derived from published literature and trilaciclib clinical trial data. Model outcomes included the number of myelosuppressive adverse events (AEs), costs of treatment, costs of AE management, total cost, and per-member per-month (PMPM) costs. The budget impact of trilaciclib was calculated as the difference in cost (2021 US dollars) between the 2 scenarios over a 1- to 5-year time horizon. Scenario and deterministic sensitivity analyses were conducted to assess uncertainty around key model inputs. RESULTS: An estimated total of 301 patients were eligible for treatment with trilaciclib over a 5-year period. The use of trilaciclib was estimated to reduce the number of myelosuppressive AEs over a 5-year period (events avoided included 108 for neutropenia, 7 for febrile neutropenia, 23 for anemia, and 46 for thrombocytopenia) compared with the scenario without trilaciclib. The adoption of trilaciclib was associated with a cost saving of $801,254 ($0.013 PMPM) over 5 years. The acquisition cost for trilaciclib ($3,704,199) was offset by the reduction in AE management cost ($4,282,748) and reduction in prophylactic granulocyte colony-stimulating factor use ($222,704). The cost savings associated with trilaciclib began in year 1 (total $34,388; $0.003 PMPM) and accrued over time. CONCLUSIONS: The acquisition cost of trilaciclib is projected to be offset by a reduction in the costs of managing AEs related to myelosuppression when added to standard chemotherapy regimens for ES-SCLC. The net budget impact of trilaciclib is estimated to be a cost saving. DISCLOSURES: This research was funded by G1 Therapeutics, Inc., and implemented by ZS Associates, an independent consultancy that collated the model inputs and performed the budget impact analysis. The study sponsor was involved in the study design; collection, analysis, and interpretation of data; writing of the report; and the decision to submit the report for publication. The journal open access fee was funded by G1 Therapeutics, Inc. Moran, Chioda, and Huang are employed by G1 Therapeutics, Inc. Chioda and Huang report stocks and stock options for G1 Therapeutics, Inc. Goyal and Deniz are employed by ZS Associates. Goyal reports consulting fees from G1 Therapeutics, Inc. Abraham reports consulting fees from Coherus, G1 Therapeutics, Inc. (unrelated to this study and manuscript), Mylan/Viatris, and Sandoz and participation on a data safety monitoring board or advisory board for G1 Therapeutics, Inc. MacDonald reports consulting fees from Coherus, G1 Therapeutics, Inc. (unrelated to this study and manuscript), Mylan/Viatris, and Sandoz. Deniz reports no disclosures. A synopsis of the current study was presented in poster format at the Virtual AMCP Annual Meeting, April 12-16, 2021. FAU - Abraham, Ivo AU - Abraham I AD - Center for Health Outcomes and PharmacoEconomic Research and Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, and University of Arizona Cancer Center, Tucson. AD - Matrix45, Tucson, AZ. FAU - Goyal, Amit AU - Goyal A AD - ZS Associates, Gurgaon, India. FAU - Deniz, Baris AU - Deniz B AD - ZS Associates, New York, NY. FAU - Moran, Donald AU - Moran D AD - G1 Therapeutics, Inc, Research Triangle Park, NC. FAU - Chioda, Marc AU - Chioda M AD - G1 Therapeutics, Inc, Research Triangle Park, NC. FAU - MacDonald, Karen M AU - MacDonald KM AD - Matrix45, Tucson, AZ. FAU - Huang, Huan AU - Huang H AD - G1 Therapeutics, Inc, Research Triangle Park, NC. LA - eng PT - Journal Article DEP - 20220131 PL - United States TA - J Manag Care Spec Pharm JT - Journal of managed care & specialty pharmacy JID - 101644425 RN - 0 (Antineoplastic Agents) RN - 0 (Pyrimidines) RN - 0 (Pyrroles) RN - U6072DO9XG (trilaciclib) SB - IM MH - *Antineoplastic Agents/adverse effects MH - Budgets MH - Humans MH - Incidence MH - *Lung Neoplasms/drug therapy MH - Pyrimidines MH - Pyrroles MH - *Small Cell Lung Carcinoma/chemically induced/drug therapy MH - United States EDAT- 2022/02/01 06:00 MHDA- 2022/03/29 06:00 CRDT- 2022/01/31 17:13 PHST- 2022/02/01 06:00 [pubmed] PHST- 2022/03/29 06:00 [medline] PHST- 2022/01/31 17:13 [entrez] AID - 10.18553/jmcp.2022.21379 [doi] PST - ppublish SO - J Manag Care Spec Pharm. 2022 Apr;28(4):435-448. doi: 10.18553/jmcp.2022.21379. Epub 2022 Jan 31.