Economic Analysis of First-Line Treatment with Erlotinib in an EGFR-Mutated Population with Advanced NSCLC
Por:
Vergnenegre, A, Massuti B, de Marinis, F, Carcereny, E, Felip, E, Do, P, Miguel Sanchez, J, Paz-Arez, L, Chouaid, C, Rosell, R, Spanish Lung Canc Grp, Italian Assoc Thoracic Oncology and French Lung Canc Grp
Publicada:
1 jun 2016
Resumen:
Introduction: The cost-effectiveness of first-line tyrosine kinase
inhibitor therapy in epidermal growth factor receptor gene
(EGFR)-mutated advanced-stage non-small cell lung cancer (NSCLC) is
poorly documented. We therefore conducted a cost-effectiveness analysis
of first-line treatment with erlotinib versus standard chemotherapy in
European patients with advanced-stage EGFR-mutated NSCLC who were
enrolled in the European Erlotinib versus Chemotherapy trial.
Methods: The European Erlotinib versus Chemotherapy study was a
multicenter, open-label, randomized phase III trial performed mainly in
Spain, France, and Italy. We based our economic analysis on clinical
data and data on resource consumption (drugs, drug administration,
adverse events, and second-line treatments) collected during this trial.
Utility values were derived from the literature. Incremental
cost-effectiveness ratios were calculated for the first-line treatment
phase and for the overall strategy from the perspective of the three
participating countries. Sensitivity analyses were performed by
selecting the main cost drivers.
Results: Compared with standard first-line chemotherapy, the first-line
treatment with erlotinib was cost saving ((sic)7807, (sic)17,311, and
(sic)19,364 for Spain, Italy and France, respectively) and yielded a
gain of 0.117 quality-adjusted life-years. A probabilistic sensitivity
analysis indicated that, given a willingness to pay at least (sic)90,000
for 1 quality-adjusted life-year, the probability that a strategy of
first-line erlotinib would be cost-effective was 100% in France, 100% in
Italy, and 99.8% in Spain.
Conclusion: This economic analysis shows that first-line treatment with
erlotinib, versus standard chemotherapy, is a dominant strategy for
EGFR-mutated advanced-stage NSCLC in three European countries. (C) 2016
International Association for the Study of Lung Cancer. Published by
Elsevier Inc. All rights reserved.
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