Evaluation of a risk-sharing agreement for atezolizumab treatment in patients with non-small cell lung cancer: a strategy to improve access in low-income countries

Oscar Arrieta ¹, Maritza Ramos-Ramírez ¹, Homero Garcés-Flores ²

⁰Thoracic Oncology Unit, Instituto Nacional de Cardiología (INCan), Mexico City 14080, México.

The Oncologist +

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October 19, 2024

View abstract on PubMed

Summary

Risk-sharing agreements (RSAs) significantly reduce the cost of immune checkpoint inhibitors (IO) for non-small cell lung cancer (NSCLC). This approach improves treatment accessibility and optimizes resource allocation for better patient outcomes.

Area Of Science

Oncology
Health Economics
Pharmacoeconomics

Background

Immune checkpoint inhibitors (IO) offer promising clinical benefits for non-small cell lung cancer (NSCLC) patients.
PD-L1 expression is a key predictor of IO treatment response.
High costs of IO therapy present significant access barriers, despite proven sustained benefits for responders.

Purpose Of The Study

To conduct a prospective cost analysis of implementing a risk-sharing agreement (RSA) for atezolizumab in NSCLC patients.
To assess the economic implications and resource allocation efficiency of RSAs in a high-specialty health facility.

Main Methods

A prospective study involving 30 advanced NSCLC patients.
Pharmaceutical company initially funded atezolizumab cycles; government program covered costs post-response until progression.
Cost-effectiveness and patient outcomes were analyzed under the RSA model.

Main Results

Median progression-free survival was 4.67 months overall, increasing to 9.4 months for responders.
The 2-year overall survival rate was 64% in responders.
The RSA model resulted in a 40% cost reduction ($530,467.12 with RSA vs. $881,859.36 without), with a 22% decrease in cost per year of life for responders. Pharmacological costs showed a statistically significant difference (P < .001).

Conclusions

Risk-sharing agreements (RSAs) are effective in optimizing resource allocation for IO therapy in NSCLC.
RSAs enhance treatment accessibility, particularly in resource-limited settings.
This model demonstrates significant cost savings and improved economic value in cancer care.

Keywords:

PD-L1 expression economic implications immune checkpoint inhibitors non-small cell lung cancer risk-sharing agreement