Budget impact of everolimus for the treatment of progressive, well-differentiated, non-functional neuroendocrine tumors of gastrointestinal or lung origin that are advanced or metastatic

Figures & data

Figure 1. Patient flow for GI and lung NET treatment. Patient counts are based on a hypothetical health plan with 1 million members.

Table 1. Treatment-eligible patient population estimates.

Parameter	References	Default value
Covered population (n)	Assumption	1,000,000
GI NETs
Prevalence (patients per 100,000, n)	Analysis of SEER data^1	35.29
Advanced disease (%)	Mocellin and Nitti^13	43.2%
Non-functional disease (%)	Choti et al.^15	72.0%
Well-differentiated NETs (%)	Yalchin et al.^17	66.8%
Treatable patients (%)	Assumption	90.0%
Lung NETs
Prevalence (patients per 100,000, n)	Analysis of SEER data^1	9.69
Advanced disease (%)	Mocellin and Nitti^13	43.2%
Non-functional disease (%)	Choti et al.^15	72.0%
Well-differentiated NETs (%)	Yalchin et al.^17	73.5%
Treatable patients (%)	Assumption	90.0%

Table 2. GI and lung NET budget impact model: total costs.

Treatment option	Annual costs ($)
	Drug cost	Administration cost	AE cost	Resource cost	Total cost per patient
GI NETs
Everolimus	112,638	0	1,138	4,440	118,217
Octreotide LAR	49,969	262	0	4,440	54,671
Lanreotide	58,840	262	409	4,440	63,951
5-fluorouracil + streptozocin	6,236	9,327	3,326	4,440	23,329
Capecitabine + oxaliplatin	44,996	2,073	445	4,440	51,954
Dacarbazine	1,744	7,773	1,389	4,440	15,346
Temozolomide	58,725	0	1,142	4,440	64,307
Lung NETs
Everolimus	112,638	0	1,138	4,380	118,156
Sunitinib	121,806	0	808	4,380	126,994
Octreotide LAR	49,969	262	0	4,380	54,611
Lanreotide	58,840	262	409	4,380	63,891
Capecitabine + temozolomide	73,609	0	398	4,380	78,387
Cisplatin + etoposide	1,141	4,664	19,982	4,380	30,167
Temozolomide	58,725	0	1,142	4,380	64,247

Figure 2. GI NET budget impact model: budget impact with and without the introduction of everolimus.

Figure 3. Lung NET budget impact model: budget impact with and without the introduction of everolimus.

Table 3. GI and lung NET budget impact model: summary of results.

Budget impact ($PMPM)	2016	2017	2018
GI NETs
Without everolimus on the market	0.3429	0.3429	0.3429
With everolimus on the market	0.3998	0.4435	0.4872
Difference	0.0568	0.1005	0.1443
Lung NETs
Without everolimus on the market	0.1324	0.1324	0.1324
With everolimus on the market	0.1505	0.1577	0.1679
Difference	0.0181	0.0253	0.0355

Figure 4. GI NET pharmacy model: budget impact with and without the introduction of everolimus.

Figure 5. Lung NET pharmacy model: budget impact with and without the introduction of everolimus.

Table 4. GI and lung NET pharmacy model: results.

Budget impact ($PMPM)	2016	2017	2018
GI NETs
Without everolimus on the market	0.2967	0.2967	0.2967
With everolimus on the market	0.3572	0.4038	0.4504
Difference	0.0606	0.1072	0.1538
Lung NETs
Without everolimus on the market	0.1162	0.1162	0.1162
With everolimus on the market	0.1366	0.1448	0.1558
Difference	0.0204	0.0285	0.0396

Figure 6. GI NET budget impact model: sensitivity analysis.

Figure 7. Lung NET budget impact model: sensitivity analysis.

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