Cost-effectiveness of lutetium (177Lu) oxodotreotide vs everolimus in gastroenteropancreatic neuroendocrine tumors in Norway and Sweden

Table 1 Drug acquisition costs for gastrointestinal-neuroendocrine tumors and pancreatic-neuroendocrine tumor

Treatment	Dose and frequency	Cost Sweden, SEK	Cost Norway, NOK
177Lu-Dotatate 7.4 GBq (Lutathera®)	4 administrations of 7.4 GBq, administered once every 8 wk	200000 per dose	228508 per dose
Octreotide LAR (Sandostatin®)	60 mg or 30 mg administered once every 28 d	11957.94 (30 mg) 23915.88 (60 mg)	13673 (30 mg) 27346 (60 mg)
Everolimus (Afinitor®)	10 mg once daily	38089.19 (1 × 30 tablet pack, 10 mg)	36525 (1 × 30 tablet pack, 10 mg)
Octreotide SC 50 μg/mL	If required	283.41 per dose	227.40 per dose
Granisetron1	3.1 mg/24 h depot patch administered prior to 177Lu-Dotatate	913.25 (1 × patch)	875.30
Ondansetron1	8 mg administered prior to 177Lu-Dotatate	1474.02 (1 × 30 tablet pack, 4 mg)	985.70 (1 × 30 tablet pack, 8 mg)
Tropisetron1	5 mg administered prior to 177Lu-Dotatate	1474.022	749.70 (1 × 5 tablet pack, 5 mg)
Vamin3	18%–18% infusion administered prior to/during 177Lu-Dotatate	458.08 (2 × 500 mL infusions)	202.8 (1 × 500 mL infusion)
Clinisol3	15% infusion administered prior to/during 177Lu-Dotatate	458.084	Not available in Norway

¹Anti-emetic required to be administered prior to administration with Lutathera.

²Cost assumed equal to ondansetron.

³Amino acid infusion required to be administered prior to and during administration of Lutathera.

⁴Cost assumed equal to Vamin. All Swedish costs are sourced from FASS (Pharmaceutical specialties in Sweden)[20]. All Norwegian costs are sourced from the Norwegian Medicines Agency[21]. PPP: Purchasing power parity; SC: Subcutaneous.