Economic Evaluation of Companion Diagnostic Testing for EGFR Mutationsand First-Line Targeted Therapy in Advanced Non-Small Cell Lung CancerPatients in South Korea
| Autor: | Haeyoung Lee, Jaeok Lim, Young Kee Shin, Eun-A Lim, Sang-Eun Choi, Eunmi Bae |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine Test strategy Oncology Lung Neoplasms Economics Cost-Benefit Analysis medicine.medical_treatment Cancer Treatment Gene Expression Social Sciences lcsh:Medicine Lung and Intrathoracic Tumors Targeted therapy 0302 clinical medicine Carcinoma Non-Small-Cell Lung Adenocarcinomas Medicine and Health Sciences Molecular Targeted Therapy Precision Medicine lcsh:Science Erlotinib Hydrochloride health care economics and organizations Multidisciplinary Adenocarcinoma of the Lung Pharmaceutics Health Care Costs Middle Aged Markov Chains ErbB Receptors 030220 oncology & carcinogenesis Female Quality-Adjusted Life Years Erlotinib Research Article medicine.drug Clinical Oncology medicine.medical_specialty Cost-Effectiveness Analysis Adenocarcinoma of Lung Antineoplastic Agents Adenocarcinoma Carcinomas 03 medical and health sciences Health Economics Drug Therapy Diagnostic Medicine Internal medicine Republic of Korea Cancer Detection and Diagnosis Adenocarcinoma of the lung medicine Humans Chemotherapy Lung cancer Intensive care medicine Protein Kinase Inhibitors Aged Neoplasm Staging business.industry Decision Trees lcsh:R Cancers and Neoplasms medicine.disease Economic Analysis Non-Small Cell Lung Cancer Quality-adjusted life year Health Care 030104 developmental biology Mutation lcsh:Q Clinical Medicine business Companion diagnostic |
| Zdroj: | PLOS ONE(11): 8 PLoS ONE, Vol 11, Iss 8, p e0160155 (2016) PLoS ONE |
| Popis: | Background As targeted therapy becomes increasingly important, diagnostic techniques for identifying targeted biomarkers have also become an emerging issue. The study aims to evaluate the cost-effectiveness of treating patients as guided by epidermal growth factor receptor (EGFR) mutation status compared with a no-testing strategy that is the current clinical practice in South Korea. Methods A cost-utility analysis was conducted to compare an EGFR mutation testing strategy with a no-testing strategy from the Korean healthcare payer’s perspective. The study population consisted of patients with stage 3b and 4 lung adenocarcinoma. A decision tree model was employed to select the appropriate treatment regimen according to the results of EGFR mutation testing and a Markov model was constructed to simulate disease progression of advanced non-small cell lung cancer. The length of a Markov cycle was one month, and the time horizon was five years (60 cycles). Results In the base case analysis, the testing strategy was a dominant option. Quality-adjusted life-years gained (QALYs) were 0.556 and 0.635, and total costs were $23,952 USD and $23,334 USD in the no-testing and testing strategy respectively. The sensitivity analyses showed overall robust results. The incremental cost-effectiveness ratios (ICERs) increased when the number of patients to be treated with erlotinib increased, due to the high cost of erlotinib. Conclusion Treating advanced adenocarcinoma based on EGFR mutation status has beneficial effects and saves the cost compared to no testing strategy in South Korea. However, the cost-effectiveness of EGFR mutation testing was heavily affected by the cost-effectiveness of the targeted therapy. |
| Databáze: | OpenAIRE |
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