| Autor: |
Vellekoop H; Institute for Medical Technology Assessment, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands., Huygens S; Institute for Medical Technology Assessment, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands., Versteegh M; Institute for Medical Technology Assessment, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands., Szilberhorn L; Syreon Research Institute, Mexikoi str. 65/A, 1142 Budapest, Hungary., Zelei T; Syreon Research Institute, Mexikoi str. 65/A, 1142 Budapest, Hungary., Nagy B; Syreon Research Institute, Mexikoi str. 65/A, 1142 Budapest, Hungary., Koleva-Kolarova R; Health Economics Research Centre, University of Oxford, Oxford OX3 7LF, UK., Wordsworth S; Health Economics Research Centre, University of Oxford, Oxford OX3 7LF, UK., Rutten-van Mölken M; Institute for Medical Technology Assessment, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. |
| Abstrakt: |
Aim: To explore variations in the cost-effectiveness of entrectinib across different testing strategies and settings. Methods: Four testing strategies where adult cancer patients received entrectinib if they tested positive for NTRK gene fusions compared with 'no testing' and standard of care (SoC) for all patients were evaluated. Results: Immunohistochemistry for all patients followed by RNA-based next-generation sequencing after a positive result was the optimal strategy in all included countries. However, the incremental net monetary benefit compared with SoC was negative in all countries, ranging between international euros (int€) -206 and -404. In a subgroup analysis with only NTRK -positive patients, the incremental net monetary benefit was int€ 8405 in England, int€ -53,088 in Hungary and int€ 54,372 in The Netherlands. Conclusion: Using the cost-effectiveness thresholds recommended by national guidelines, none of the testing strategies were cost-effective compared with no testing. The implementation of entrectinib is unlikely to become cost-effective in Hungary, due to the large cost difference between the entrectinib and SoC arms, while there might be more potential in England and The Netherlands. |
