Drugs, Health Technologies, Health Systems

Reimbursement Recommendation

Atezolizumab (Tecentriq IV and Tecentriq SC)

Indication: As monotherapy for the first-line treatment of patients with metastatic NSCLC whose tumours have high PD-L1 expression (PD-L1 stained ≥ 50% of TCs or PD-L1 stained tumour-infiltrating immune cells [ICs] covering ≥ 10% of the tumour area), as determined by a validated test and who do not have EGFR or ALK genomic tumour aberrations

Sponsor: Hoffmann-La Roche Limited

Final recommendation: Reimburse with conditions

Summary

What Is the Reimbursement Recommendation for Tecentriq?

Canada’s Drug Agency (CDA-AMC) recommends that Tecentriq IV and Tecentriq SC be reimbursed by public drug plans for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumours have high PD-L1 expression, as determined by a validated test, and who do not have EGFR or ALK genomic tumour aberrations if certain conditions are met.

Why Did CDA-AMC Recommend Reimbursement?

A subcommittee of the pan-Canadian Oncology Drug Review Expert Review Committee (pERC) determined that Tecentriq IV and SC demonstrate acceptable clinical value versus immunotherapies (i.e., pembrolizumab and cemiplimab) in patients with metastatic NSCLC. This determination was enough for pERC to recommend that Tecentriq IV and SC be reimbursed. Given that Tecentriq is expected to be an alternative to pembrolizumab and cemiplimab, acceptable clinical value refers to at least comparable value versus the PD-1 inhibitors.

Evidence from a clinical trial (IMpower110) showed that treatment with Tecentriq delays cancer progression and extends life compared with chemotherapy alone in patients with NSCLC that has spread to other parts of the body.

Patients identified a need for additional treatment options that are life extending and improve their quality of life. Tecentriq was considered an alternative immunotherapy option, with both IV and subcutaneous (SC) routes of administration that may offer an unmet clinical benefit for some patients.

Which Patients Are Eligible for Coverage?

Tecentriq should only be covered according to the criteria used by the public drug plans for other PD-1 inhibitors for the first-line treatment of patients with metastatic NSCLC whose tumours have high PD-L1 expression.

What Are the Conditions for Reimbursement?

In addition to the pre-existing criteria for other PD-1 inhibitors, Tecentriq should only be reimbursed if it is not used in combination with another anticancer therapy, if it is prescribed by a clinician with expertise in managing lung cancer, and if the cost of Tecentriq does not exceed the drug program cost of treatment with the least costly PD-1 inhibitor monotherapy for the same indication.

Review Background

Highlights of Input From Interested Parties

The patient groups (Lung Cancer Canada, the Lung Health Foundation, and the Canadian Cancer Survivor Network) noted the following regarding impacts of the disease, unmet needs, and important outcomes:

The clinician groups (the Lung Cancer Canada Medical Advisory Committee and the Ontario Health [Cancer Care Ontario] Lung Cancer Drug Advisory Committee) and the clinical experts consulted by CDA-AMC noted the following regarding unmet needs arising from the disease and place in therapy for the drug under review:

The participating public drug programs raised potential implementation issues related to considerations for initiation, renewal, and discontinuation; generalizability of trial populations to broader populations; and system and economic issues.

Recommendation

The pERC subcommittee recommends that atezolizumab IV and SC be reimbursed as monotherapy for the first-line treatment of patients with metastatic NSCLC whose tumours have high PD-L1 expression, as determined by a validated test, and who do not have EGFR or ALK genomic tumour aberrations, only if the conditions listed in Table 1 are met.

Table 1: Reimbursement Conditions and Reasons

Reimbursement condition

Reason

Implementation guidance

Initiation

1. Eligibility for atezolizumab (IV or SC) should be based on the criteria used by each of the public drug plans for reimbursement of PD-1 inhibitors as monotherapy for the first-line treatment of patients with metastatic NSCLC whose tumours have high PD-L1 expression.

There is insufficient evidence that atezolizumab is clinically superior or inferior to pembrolizumab or cemiplimab for the first-line treatment of patients with metastatic NSCLC whose tumours have high PD-L1 expression.

Existing criteria: The initiation criteria for pembrolizumab and cemiplimab may vary across participating drug programs, but are summarized as 1 of the following:

  • PD-L1 stained ≥ 50% of tumour cells

  • no prior treatment in the relevant line of therapy (i.e., metastatic disease)

  • no EGFR, ALK, or ROS1 mutations

  • no uncontrolled or symptomatic CNS metastases

  • good performance status.

Locally advanced disease: The scope of the CDA-AMC review was limited to the indication that has been approved by Health Canada and does not include patients with stage III disease or locally advanced disease; however, the pERC subcommittee and the clinical experts noted it could be appropriate for jurisdictions to reimburse atezolizumab for the same patient populations the PD-1 inhibitors are currently reimbursed for (i.e., pembrolizumab and cemiplimab).

Prior PD-1 or PD-L1 inhibitor: Consistent with the reimbursement criteria for pembrolizumab and cemiplimab, patients who received prior treatment with an anti–PD-1 or anti–PD-L1 therapy in the nonmetastatic setting (e.g., neoadjuvant or adjuvant setting) should be eligible for atezolizumab in the first-line metastatic setting if progression to metastatic disease occurred at least 6 months after the completion of the prior anti–PD-1 or anti–PD-L1 therapy in the advanced disease setting.

Discontinuation

2. Discontinuation of reimbursement for atezolizumab should be based on the criteria used by each of the public drug plans for the reimbursement of PD-1 inhibitors as monotherapy for the first-line treatment of patients with metastatic NSCLC whose tumours have high PD-L1 expression.

The existing discontinuation criteria for pembrolizumab and cemiplimab are appropriate for atezolizumab.

Existing criteria: The discontinuation criteria for pembrolizumab and cemiplimab may vary across participating drug programs, but are summarized as 1 of the following:

  • disease progression

  • unacceptable toxicity.

Interruption due to toxicity: Patients who previously discontinued atezolizumab due to toxicity and for whom the toxicity has subsequently resolved should be eligible for reimbursement until the discontinuation criteria are met.

Relapse after complete response: Patient who experiences a relapse after discontinuing atezolizumab due to a confirmed complete response should be eligible for reimbursement until the discontinuation criteria are met.

Duration of treatment: The product monograph for atezolizumab does not specify a maximum number of doses and the IMpower110 trial did not stop administration after a maximum number of cycles. As such, there is no evidence to inform a reimbursement condition that would limit administration of atezolizumab to a maximum number of cycles. However, pERC agreed with the clinical experts consulted by CDA-AMC that alignment of treatment duration with other currently reimbursed treatment options (i.e., pembrolizumab and cemiplimab, which have a maximum treatment duration of 2 years and re-treatment up to an additional 1 year if certain conditions are met) in this setting would be appropriate.

Disease progression: Reimbursement for pembrolizumab and cemiplimab is discontinued at the time of disease progression. Although the product monograph for atezolizumab states that treatment may continue until loss of clinical benefit, the subcommittee concluded that reimbursement of atezolizumab should be discontinued at the time of disease progression. This will ensure alignment of the reimbursement criteria for atezolizumab, pembrolizumab, and cemiplimab.

Prescribing

3. Atezolizumab should be prescribed by clinicians with expertise in managing lung cancer.

This is meant to ensure that atezolizumab is prescribed for appropriate patients and that adverse effects are managed in an optimized and timely manner.

4. Reimbursement should be provided for atezolizumab monotherapy and not when used in combination with other anticancer therapies.

This condition aligns with the indication under review.

Pricing

5. The drug program cost of atezolizumab should be negotiated so it does not exceed the drug program cost of treatment with the least costly PD-1 inhibitor monotherapy for the same indication.

Based on the subcommittee’s assessment of the evidence, atezolizumab is expected to have comparable clinical benefits and harms to relevant comparators. Therefore, atezolizumab should be priced such that the total treatment cost for atezolizumab is no more than that of the least costly PD-1 inhibitor.

The duration of treatment with atezolizumab may be longer than other PD-1 inhibitors if a maximum number of cycles is not applied. Even if the price of atezolizumab is negotiated to not exceed the drug program cost of treatment with the least costly of pembrolizumab or cemiplimab, expenditure on atezolizumab may increase the overall budgetary amount spent by the drug plans. Additional price reductions beyond that recommended in the pricing condition may be necessary to avoid increasing the overall budget.

CDA-AMC = Canada’s Drug Agency; CNS = central nervous system; NSCLC = non–small cell lung cancer; pERC = pan-Canadian Oncology Drug Review Expert Review Committee; SC = subcutaneous.

Rationale for the Recommendation

Clinical Value

The pERC subcommittee deliberated on whether the evidence supports that atezolizumab demonstrates comparable clinical benefit and harms to 1 or more appropriate comparators for first-line treatment of patients with metastatic NSCLC whose tumours have high PD-L1 expression, as determined by a validated test, and who do not have EGFR or ALK genomic tumour aberrations. Based on the totality of the clinical evidence, the subcommittee concluded that atezolizumab demonstrates comparable clinical benefit and harms to pembrolizumab and cemiplimab and therefore has acceptable clinical value.

Evidence from a pivotal phase III clinical trial (IMpower110) demonstrated that atezolizumab results in clinically meaningful improvements compared with platinum-based chemotherapy in outcomes that are relevant for the management of NSCLC in the first-line metastatic setting, including overall survival (OS), progression-free survival (PFS), and objective response. The estimates of effect from the sponsor’s network meta-analysis (NMA) were limited by imprecision (i.e., wide credible intervals [CrIs]), making it challenging to evaluate if there are meaningful differences across the different PD-1 and PD-L1 inhibitors (i.e., atezolizumab, pembrolizumab, and cemiplimab) approved for use in the target population. The subcommittee concluded that atezolizumab is likely associated with similar clinical benefits to pembrolizumab and cemiplimab (i.e., consistent with the sponsor’s claim of no added clinical benefit) based on the effect sizes reported in the IMpower110 trial, the input from clinical specialists, and the similar mechanism of action compared with PD-1 inhibitors.

The sponsor’s application is seeking reimbursement for both the IV and SC formulations of atezolizumab. There was no data for the SC formulation submitted for the target patient population, as the SC formulation was evaluated in a different clinical development program. The SC formulation was approved by Health Canada in March 2024, and the subcommittee accepted the extrapolation of the indications approved for the IV formulation to the SC formulation.

Patients and clinicians noted that reimbursement of atezolizumab would be beneficial as it would provide an SC treatment option for this patient population.

Further information on the subcommittee’s discussion around clinical value is provided in the Summary of Deliberation section.

Developing the Recommendation

The determination of acceptable clinical value was sufficient for the pERC subcommittee to recommend reimbursement of atezolizumab.

Because the pERC subcommittee recommended that atezolizumab be reimbursed, it also deliberated on whether reimbursement conditions should be added to address important economic considerations, health system impacts, or social and ethical considerations, or to ensure clinical value is realized. The resulting reimbursement conditions, with accompanying reasons and implementation guidance, are stated in Table 1.

Summary of Deliberation

The subcommittee considered all domains of value of the deliberative framework before developing its recommendation: clinical value, unmet clinical need, distinct social and ethical considerations, economic considerations, and impacts on health systems. For further information on the domains of value, refer to Expert Committee Deliberation at Canada’s Drug Agency.

The subcommittee considered the following key discussion points, organized by the 5 domains of value.

Clinical Value

Unmet Clinical Need

Distinct Social and Ethical Considerations

Economic Considerations

Impacts on Health Systems

Sources of Information Used by the Subcommittee

To make its recommendation, the subcommittee considered the following information (links to the full documents for the review can be found on the project webpage).

pERC Information

Members of the Committee

Dr. Catherine Moltzan (Chair), Dr. Kelvin Chan (Vice-Chair), Paul Agbulu, Dr. Phillip Blanchette, Dr. Matthew Cheung, Dr. Michael Crump, Annette Cyr, Dr. Jennifer Fishman, Dr. Jason Hart, Terry Hawrysh, Dr. Yoo-Joung Ko, Dr. Aly-Khan Lalani, Amy Peasgood, Dr. Anca Prica, Dr. Michael Raphael, Dr. Adam Raymakers, Dr. Patricia Tang, Dr. Pierre Villeneuve, and Danica Wasney

A subcommittee composed of 4 pERC members was convened. None had a conflict of interest that precluded their participation.

Meeting date: November 17, 2025

Conflicts of interest: None