OBJECTIVES : To estimate the budgetary impact from the introduction of trifluridine/tipiracil (FTD/TPI) as a third-line treatment option for patients with metastatic gastric cancer(mGC), including adenocarcinoma of the gastroesophageal junction(GEJ), among patients who have received at least two prior therapies for metastatic disease in Greece.

METHODS : A budget impact model was developed from a public payer perspective over a 5-year time horizon to estimate the financial impact of FTD/TPI by taking market shares from available treatments options in Greece. Based on local experts, patients with mGC are currently treated with irinotecan, nivolumab, ramucirumab and pembrolizumab, which represents common clinical practice in the absence of any other recommendation. The model framework considered market share scenarios with and without FTD/TPI and reimbursed costs of treatment applied to the eligible Greek patient population. The number of eligible patients was estimated using data from published literature and local experts. The projected uptake of FTD/TPI was provided by Servier. Drug acquisition and drug administration cost of treatments were considered in the analysis and were retrieved from the Greek Ministry of Health. The model-measured outcome was incremental budget impact from the introduction of FTD/TPI as a third-line treatment option in patients with mGC.

RESULTS : Over the 5-year horizon, the total number of the eligible population was 209 patients per year and the number of Greek patients who received FTD/TPI was 21, 63, 84, 105, 105 in the years 1 to 5, respectively. The annual incremental cost associated with the introduction of FΤD/ΤPI was €11,728, €35,184, €46,912, €58,639, and €58,639 for years 1 to 5 respectively, resulting in a total 5-year budget impact of €211,102.

CONCLUSIONS : In addition to the clinical benefits, the introduction of FTD/TPI as a third-line treatment option for patients with mGC was predicted to be associated with a limited budget increase for the payer.