Patient access to precision medicine: Immune checkpoint inhibitor (ICI) usage in non-small cell lung cancer (NSCLC) and association with income levels across multiple Asian markets.

Abstract

e13743 Background: Regimens containing ICIs are now considered the recommended treatment option for 1 st line (1L) advanced/metastatic NSCLC patients who are wild-type (WT) for EGFR, ALK and ROS1. However, due to their cost, some patients are unable to afford these treatment options, especially in countries where reimbursement coverage is partial or absent. This study uses real-world data to investigate the correlation between monthly household income levels (MHHI) and ICI shares in Thailand, Vietnam, Taiwan and Mainland China, and how this has evolved since 2022. Methods: Ipsos’ Oncology Monitor is a physician-reported syndicated patient record database. Between July 2021 and June 2022, 502 cancer-treating physicians (Thailand=37, Vietnam=80, Taiwan=40, China=345) were screened for specialty, role and caseload, and submitted data on 1,069 1L WT stage IIIB/IV NSCLC patients (aggregate) with known MHHI. This was compared to data collected between July 2024 and June 2025, based on data from 365 cancer-treating physicians (Thailand=27, Vietnam=84, Taiwan=53, China=201) reporting on 1,342 patients. Results: In 3 out of 4 countries, an association was observed between MHHI and the percentage of reported WT patients in each cohort receiving an ICI as part of their current 1L therapy, across both time points. In Taiwan, this association was observed in the earlier time point, but was not noted in the most recent dataset. In Mainland China, ICI uptake increased across all MHHI cohorts, but remained the highest in the highest-income segment. In Thailand and Vietnam, no progress was made in increasing access to ICIs among the lowest-income segments between July 2021 and June 2025. Conclusions: In the two South-East Asian markets included in this study, access to ICIs remains largely limited to those with higher MHHIs. While access in Mainland China has increased across all income segments and is relatively high overall, a disparity between those in the highest MMHI band and the other MMHI groups continues to exist. Only Taiwan is now displaying a relatively equal usage across all MMHI segments. More progress must be made across the region to ensure equal access to optimal treatments for all. Thailand Vietnam Taiwan Mainland China MHHI <39,999 THB MHHI 40,000 - 100,000 THB MHHI >100,000 THB MHHI <7,500,000 VND MHHI 7,500,000 - 12,000,000 VND MHHI >12,000,000 VND MHHI <40,000 NTD MHHI 40,000-100,000 NTD MHHI >100,000 NTD MHHI <7,000 CNY MHHI 7,000-9,999 CNY MHHI >10,000 CNY % of reported patients in each cohort receiving an ICI as part of their current 1L therapy for WT stage IIIB/IV NSCLC 2021-2022(n), % (20)10% (17)53% (24)79% (42)7% (109)5% (135)39% (24)21% (66)36% (20)35% (141)32% (173)36% (298)51% 2024-2025(n), % (18)6% (24)58% (33)67% (67)3% (131)2% (268)29% (42)29% (121)31% (46)33% (111)57% (133)54% (221)67%