As of 12 March 2026, the Health Technology Assessment Council has completed the evidence appraisal on the assessment of Pembrolizumab (100 mg/4 mL [25 mg/mL] solution for IV infusion) and Atezolizumab (1200 mg/20 mL [60 mg/mL] concentrate for solution for IV infusion) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with positive Programmed Death-Ligand 1 (PD-L1) expression (tumor proportion score [TPS] >1%), and without targetable mutations (oncogene-driver wild-type), for government financing. Immune checkpoint inhibitors, including Atezolizumab and Prembrolizumab, now represent the standard of care for the majority of patients with metastatic NSCLC.
As such, the HTA Council hereby releases its preliminary recommendation on the said health technologies for stakeholder feedback and comments from 12 to 27 March 2026.
These health technologies were reviewed vis-à-vis the Philippine Food and Drug Administration (FDA) marketing authorization status, clinical practice guidelines (CPGs) [local and approved by the Department of Health (DOH), such as the DOH Omnibus Health Guidelines (OHG); and/or international CPGs adopted by the relevant local medical society], and existing recommendations by the World Health Organization (WHO). Furthermore, a costing analysis of the use of the health technologies was performed.
As a preliminary recommendation, the HTA Council recommends the government financing of Pembrolizumab (100 mg/4 mL [25 mg/mL] solution for IV infusion) and Atezolizumab (1200 mg/20 mL [60 mg/mL] concentrate for solution for IV infusion) for the first-line treatment of patients with metastatic NSCLC with positive PD-L1 expression (TPS>1%), and without targetable mutations (oncogene-driver wild-type).
Due to the substantial budget impact of financing these drugs which may require targeting or prioritization within the eligible population, the government may consider prioritizing the coverage for patients with higher PD-L1 expression (TPS ≥50%), given the greater magnitude of clinical benefit observed in this subgroup. Moreover, the DOH should strongly consider conducting price negotiations to ensure affordability and sustainable access to these treatments. Furthermore, the HTA Council recognizes the need for proper PD-L1 testing to identify patients eligible for this treatment and recommends that the PhilHealth or DOH consider prioritizing PD-L1 testing for HTA nomination to support the use of the therapies being recommended.
Overall, based on current evidence, Pembrolizumab and Atezolizumab are considered the standards of care for patients with metastatic NSCLC.