Cost-effectiveness analysis of the first-line EGFR-TKIs in patients with advanced EGFR-mutated non-small-cell lung cancer
| Autor: | Vicente Gimeno-Ballester, Cristina Trigo-Vicente, J Milara, Julio Cortijo, J Aguilar-Serra, Alfonso Pastor-Clerigues |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Lung Neoplasms Cost effectiveness Afatinib Cost-Benefit Analysis chemistry.chemical_compound Erlotinib Hydrochloride Gefitinib Internal medicine Carcinoma Non-Small-Cell Lung medicine Humans heterocyclic compounds Pharmacology (medical) Osimertinib Lung cancer neoplasms Protein Kinase Inhibitors business.industry Health Policy Bayes Theorem General Medicine Cost-effectiveness analysis medicine.disease Dacomitinib respiratory tract diseases ErbB Receptors chemistry Mutation Erlotinib business medicine.drug |
| Zdroj: | Expert review of pharmacoeconomicsoutcomes research. 22(4) |
| ISSN: | 1744-8379 |
| Popis: | To evaluate the cost-effectiveness of first-line treatments, such as erlotinib, gefitinib, afatinib, dacomitinib, and osimertinib, for patients diagnosed with stage IIIB/IV NSCLC harboring EGFR mutations.A partitioned survival model was developed to estimate quality-adjusted life-year (QALY) and incremental cost-effectiveness ratio (ICER) from the perspective of the Spanish National Health System. Two Bayesian NMAs were performed independently, by using the polynomial fraction method to fit Kaplan-Meier curves for overall survival and progression-free survival. Deterministic and probabilistic sensitivity analyses were performed to evaluate the uncertainty.The ICER was calculated for the four first-line treatments by comparing them with gefitinib, and the ratios obtained were as follows: €166,416/QALY for osimertinib, €183,682/QALY for dacomitinib, €167,554/QALY for afatinib, €36,196/QALY for erlotinib. It was seen that patients who received osimertinib presented higher QALYs (0.49), followed by dacomitinib (0.33), afatinib (0.32), erlotinib (0.31), and gefitinib (0.28).Gefitinib is the most cost-effective treatment. In terms of QALYs gained, Osimertinib was more effective than all other TKIs. Nevertheless, with a Spanish threshold of €24,000/QALY, the reduction in the acquisition cost of osimertinib will have to be greater than 70%, to obtain a cost-effectiveness alternative. |
| Databáze: | OpenAIRE |
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