What Is the CADTH Reimbursement Recommendation for Tecentriq?: CADTH recommends that Tecentriq be reimbursed by public drug plans after surgery and chemotherapy for the treatment of patients with stage II to stage IIIA non–small cell lung cancer (NSCLC) whose tumour is positive for programmed death-ligand 1 (PD-L1) in at least 50% of tumour cells (TCs) and does not have an abnormal EGFR or ALK gene if certain conditions are met.

Which Patients Are Eligible for Coverage?: Tecentriq should only be covered to treat adult patients (18 years or older) with stage II to stage IIIA NSCLC whose tumour is positive for PD-L1 in at least 50% of TCs and does not have an abnormal EGFR or ALK gene.

What Are the Conditions for Reimbursement?: Tecentriq should only be used alone after surgery and chemotherapy. Tecentriq should only be reimbursed if it prescribed by a specialist and if the patient is in relatively good health (i.e., has a good performance status, as determined by a specialist). Tecentriq should not be reimbursed if the patient is not a candidate for surgery or chemotherapy. The cost of Tecentriq must be lowered to be cost-effective and affordable.

Why Did CADTH Make This Recommendation?:

1. Evidence from a clinical trial demonstrated that Tecentriq lowered the chances of cancer returning compared to best supportive care.

2. Based on CADTH’s assessment of the health economic evidence, Tecentriq does not represent good value to the health care system at the public list price. A price reduction is therefore required.

3. Based on public list prices, it is estimated that Tecentriq will cost the public drug plans approximately $59 million over the next 3 years.

What is Early-Stage NSCLC?: NSCLC is the most common type of lung cancer. In those with NSCLC, unusual growth of cells takes place inside the lungs or lining of the airways and forms into tumours. Cancer that is stage I, II, or IIIA is considered early stage, meaning the tumour has not spread to other parts of the body.

Unmet Needs in NSCLC: The intention of surgery for early-stage NSCLC is to cure patients. However, it is possible for cancer to return for some patients who have had surgery; therefore, there is a need for treatment options that can prevent cancer from returning.

How Much Does Tecentriq Cost?: Treatment with Tecentriq is expected to cost approximately $9,035 per 28-day cycle.