Reducing the Financial Burden of Prolonged Therapy in Advanced/Metastatic Lung Cancer, Saving Methodology

Abstract

Value of the monoclonal antibodies (MABs) and targeted therapy (TT) have been extensively addressed in advanced/metastatic non-small cell lung cancer (a/d-NSCLC). Costs, however, have been largely overlooked. The MABs were approved at 2-year- overall survival and (TT) at 3-year- survival. The TT is currently continued as long as efficacious and safe. Drug costs were proportional to duration of therapy (Guirgis, ESMED, 2024). There is a pressing need for cost cutting and saving methodology, fair, voluntary and equitable for patients and pharma.

Our purpose: A- Demonstrate the unnecessarily high cost of MABs 3 rd year in a/d-NSCLC. B- Pay in full payment the 1 st - TT 3-years but reduce by 50% the cost of the 4 th year and throughout the entire course.

Methods

MABs costs were calculated as dose in mg x United States price x number of years and TT as the monthly optimal dose x 12 x duration of use.

Results

The median yearly cost of 5-MABs was $163,640. In view of overall survival outcome, the 2-year $327,2802 cost was justified. However, the 3- year $490,920 cost was considered unnecessary due to lack of further survival improvement. 2 The annual TT median cost was $229,600, 4- years $918,400 and the 10- years $2,296,000. Treatment of 1,000 patients in the United States by all TT for 4-years would cost $918,400,000 and in Europe 2,000 patients would mount to $1,836,800,000. Costs continue to multiply with every extended year. Applying a 50% reduction to the 4 th year of $229,600, the potential saving was $114,800. The 4-year total payments would be $229,600 x 3 + $114,800 = $803,600, instead of $918,400. The 10-year $2,296,000 cost would drop to $1,492,400.

Conclusion

In a/d-NSCLC, a 3 rd year-MABs cost was considered unnecessary due to lack of further survival improvement. A 50% reduction of TT annual costs beginning the 4 th -year and throughout the course would significantly attenuate the heavy financial burden of prolonged use.