{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:06:44Z","timestamp":1752538004361,"version":"3.41.2"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T00:00:00Z","timestamp":1740873600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T00:00:00Z","timestamp":1740873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Bristol Myers Squibb Chile","award":["CW39161"],"award-info":[{"award-number":["CW39161"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Transl Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Effective and sustainable treatments to improve patient outcomes are urgently needed for non-small cell lung carcinoma (NSCLC). Neoadjuvant therapies, particularly nivolumab, have shown superior outcomes in event-free survival and pathological response, yet financial coverage is scarce. We aim to provide an exploratory economic analysis to assess the implications of its incorporation into routine clinical practice.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a six-step BIA (budget impact analysis) based on a decision tree model for pathways, probabilities, and resource utilization from the national payer perspective at an event-free survival (EFS) horizon. We estimated the direct cost of drugs and all healthcare-related services for two scenarios: a baseline scenario [neoadjuvant chemotherapy (CT)] and an alternative scenario [neoadjuvant nivolumab combined with chemotherapy (N\u2009+\u2009CT)].<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The funnel-down technique determined 359 eligible patients nationwide per year. The total cost of treatment in the baseline scenario amounts to CLP $ 7315 million Chilean pesos (\u20ac 8,063,219) per cohort, with three top cost drivers: 1L drugs after recurrence (51.98%), resection (29.33%) and 2L nivolumab (5.85%). The alternative scenario amounted to CLP $ 6853 million (\u20ac 7,553,572), with the highest relative expenditure attributed to the N\u2009+\u2009CT scheme (61.76%), resection (31.31%), and follow-up (2.73%). Adjuvant costs decrease to 1.03%, as does the expenditure on 1L (51.98% versus 0.34%) and 2L treatments (5.85% versus 0.18%). Early intervention in NSCLC reduces the budgetary impact by 6.3% (savings of \u2212\u00a0$ 462 million (\u20ac 509,647) per treated cohort).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Early incorporation of N\u2009+\u2009CT optimizes healthcare expenditure by providing access to therapies that improve survival rates while reducing the need for costly treatments in advanced stages. This approach represents a dominant strategy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s12094-025-03872-7","type":"journal-article","created":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T06:46:52Z","timestamp":1740898012000},"page":"3375-3385","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Budget impact analysis of neoadjuvant nivolumab for non-small cell lung cancer in the Chilean public healthcare system: An exploratory economic assessment"],"prefix":"10.1007","volume":"27","author":[{"given":"Daniela","family":"Paredes-Fern\u00e1ndez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6417-3029","authenticated-orcid":false,"given":"Rony","family":"Lenz-Alcayaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Orlandi-Jorquera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,2]]},"reference":[{"key":"3872_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74:229\u201363. https:\/\/doi.org\/10.3322\/caac.21834.","journal-title":"CA Cancer J Clin"},{"key":"3872_CR2","doi-asserted-by":"publisher","first-page":"21","DOI":"10.34052\/rispch.v5i2.145","volume":"5","author":"HA Rojas Hitschfeld","year":"2021","unstructured":"Rojas Hitschfeld HA. An\u00e1lisis epidemiol\u00f3gico: Mortalidad por c\u00e1ncer de pulm\u00f3n e indicadores de consumo de cigarrillo en Chile 2010\u20132018. 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Scoping review of anticancer drug utilization in lung cancer patients at the end of life. Clin Transl Oncol. 2024. https:\/\/doi.org\/10.1007\/s12094-024-03711-1.","journal-title":"Clin Transl Oncol"},{"key":"3872_CR5","unstructured":"Ministerio de Salud. Aprueba Garant\u00edas Expl\u00edcitas en Salud del R\u00e9gimen General de Garant\u00edas en Salud. Decreto N\u00b0022. 022 Chile. 2019. pp. 96\u20137. https:\/\/diprece.minsal.cl\/wp-content\/uploads\/2019\/09\/DECRETO-N%C2%B022-01-07-2019.pdf."},{"key":"3872_CR6","unstructured":"Food and Drug Administration. 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The investigators maintained complete independence throughout all study phases, from design to the interpretation of the results. Bristol Myers Squibb Chile was not involved in data collection, analysis, or manuscript preparation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}