Interventions of Interest:

  • Tyrosine kinase inhibitors:
  • Afatinib (Gilotrif®, Boehringer Ingelheim Pharmaceuticals, Inc.)
  • Erlotinib (Tarceva®, Genentech, Inc. and Astellas Pharma US, Inc.)
  • Gefitinib (Iressa®, AstraZeneca)
  • Immunotherapies targeting the programmed death 1 (PD-1) receptor or its ligand (PD-L1):
  • Atezolizumab (Tecentriq®, Genentech, Inc., Roche Group)
  • Nivolumab (Opdivo®, Bristol-Meyers Squibb Co.)
  • Pembrolizumab (Keytruda®, Merck & Co.)

Lung cancer is the number one cause of cancer death in the United States, expected to cause 158,000 deaths in 2016, and accounting for 26.5% of all cancer deaths. It is the second most common cancer in both men (after prostate cancer) and women (after breast cancer), with 118,000 and 106,000 new cases expected in 2016, respectively. Lung cancer includes different pathological types, broadly divided into small-cell lung cancer and non-small-cell lung cancer (NSCLC). NSCLC makes up about 85% of lung cancers and comprises mainly squamous cell carcinoma, adenocarcinoma, and large-cell lung cancer. Stage at diagnosis is a primary factor in patient survival, and patients with NSCLC commonly present with advanced disease.

The council voted that the prices for TKIs well aligned with added benefits for patients, while the prices for PD-1s are too high.

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Final Documents

Below you will find the final documents from the assessment review process:

“As confirmed by votes of the Midwest CEPAC, the evidence on TKIs and PD-1 immunotherapies demonstrates important clinical benefits for patients over previous options.  PD-1 immunotherapies, in particular, offer substantial improvements in both length of life and in quality of life outcomes most important to patients. But even as helpful as PD-1 immunotherapies can be for many patients, their list prices outstrip the range needed to provide reasonable long-term value for money.  Our major challenge is therefore how to reward this kind of innovation and bring it into practice without breaking the bank.  Our Final Report captures key perspectives from the policy roundtable on ways to align pricing, payment, and coverage policies for these drugs to help patients get access to them in a manner that is more affordable – for them, and for the entire health care system.  Ultimately, we hope our report will spur productive conversation between all stakeholders to find solutions that will help as many patients as possible benefit from these treatments.”