Pharmacoeconomic Review Report: Telotristat Ethyl (Xermelo): (Ipsen Biopharmaceuticals Canada Inc.): Indication: Refractory carcinoid syndrome diarrhea, in combination with somatostatin analogue (SSA) therapy, in patients inadequately controlled by SSA therapy alone

Telotristat ethyl (Xermelo) is a tryptophan hydrolase inhibitor indicated for the treatment of refractory carcinoid syndrome diarrhea, in combination with somatostatin analogue (SSA) therapy, in patients whose condition is inadequately controlled by SSA therapy alone. Carcinoid syndrome occurs in patients with neuroendocrine tumour (NET). The manufacturer’s submission reports that, in Canada, approximately 0.45 per 100,000 people may have carcinoid syndrome diarrhea inadequately controlled with first-line SSA therapies. Telotristat ethyl is available as a 250 mg oral tablet to be taken three times daily and is priced at $84.82 per tablet. The manufacturer submitted a cost-utility analysis of telotristat in combination with SSA therapy compared with SSA monotherapy over a 30-year time horizon.