Background and importance Osimertinib improves progression free survival (PFS) in previously untreated patients with EGFR mutated non-small cell lung cancer (NSCLC). However, its profitability has not been established in a third level hospital.

Aim and objectives The aim of the study was to evaluate the cost effectiveness of osimertinib in patients with mutated EFGR NSCLC compared with other tyrosine kinase inhibitors (TKIs).

Material and methods This was a cost effectiveness study of osimertinib in patients with EFGR mutated NSCLC in a third level hospital over a period of 1 year of treatment (1 January 2018 to 12 January 2019). The protocol of the hospital was reviewed to include all therapeutic alternatives: afatinib, gefitinib and erlotinib.

The main variable of the study was the incremental cost effectiveness ratio (ICER) of osimertinib compared with other TKIs. Secondary variables included: cost of treatment per month (€), efficacy (life months gained), total cost of treatment (€) and incremental cost of osimertinib compared with other TKIs.

ResultsThe incremental cost effectiveness ratios of osimertinib compared with each TKI were:

• Osimertinib versus erlotinib: €6896/month of PFS.

• Osimertinib versus gefitinib: €7931/month of PFS.

• Osimertinib versus afatinib: €7067/month of PFS.

Conclusion and relevance At the current commercialised price, firstline osimertinib therapy in patients with EGFR mutant NSCLC would mean an incremental cost of €7455±€439 per month of PFS gained compared with other TKIs. If we consider a year of treatment, the incremental cost of osimertinib would be an additional €74547±4388. The reduction in cost of osimertinib would significantly improve its cost effectiveness profile. The main limitation of this study was that the cost of the complete treatment was calculated using the drug’s PVL.

References and/or acknowledgements No conflict of interest.