A comparison of the estimated costs of erlotinib, docetaxel and pemetrexed for the second-line treatment of non-small cell lung cancer from the German healthcare perspective

Kotowa, W; Gatzemeier, U.; Pirk, O; Gabriel, Anja; Heigener, David F.

doi:10.3111/13696990701438637

Cited by 11 publications

(18 citation statements)

References 10 publications

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“…The base case considered a health plan involving 500,000 enrolees, and found inclusion of erlotinib to have a very small impact on annual healthcare budgets when used for 30% of second-line and 90% of third-line treatments (increase of US $ 1,450 per year in 2005). Dominance for erlotinib over docetaxel has been demonstrated in the UK 29 , The Netherlands 30 , Poland 31 and Spain 32 , and cost savings versus docetaxel have been shown in Germany33 . In the later analysis, direct costs were estimated per quarter within the German statutory health insurance system.…”

mentioning

confidence: 98%

Cost-minimisation analysis of erlotinib in the second-line treatment of non-small-cell lung cancer: a Brazilian perspective

Stefani

Saggia

Santos

2008

Journal of Medical Economics

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confidence: 98%

Cost-minimisation analysis of erlotinib in the second-line treatment of non-small-cell lung cancer: a Brazilian perspective

Stefani

Saggia

Santos

2008

Journal of Medical Economics

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“…However, until now predictive factors for the precise qualification for particular second-line therapies still remain to be established. Moreover, the costs of the different types of second-line therapies have a decisive impact on the choice of treatment in many developing countries [18,19,20]. …”

Section: Introductionmentioning

confidence: 99%

The Qualification of Docetaxel or Erlotinib for Second-Line Therapy Should Be Based on Clinical and Molecular Predictive Factors

et al. 2012

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Background: We evaluated the effectiveness of docetaxel or erlotinib in second-line treatment of non-small cell lung cancer (NSCLC) and focused on the impact of predictive factors on the outcome of therapy. Methods: 204 patients with progressive disease after platinum-based therapy were enrolled: 102 received an infusion of 75 mg/m² of docetaxel and 102 received 150 mg of erlotinib orally. Results: Response rate (RR) was 6.9 and 8.8% for docetaxel and erlotinib, respectively. Progression-free survival (PFS) was 1.2 months for docetaxel and 1.6 months for erlotinib (hazard ratio, HR = 1.2, p = 0.17). Overall survival was 5.5 versus 7 months for docetaxel and erlotinib, respectively (HR = 1.35, p = 0.06). Using Cox regression, we found clinical factors (performance status and weight loss) with predictive values for RR and PFS in second-line-treated patients. Prior radiotherapy, smoking status and EGFR mutation might help to predict outcome of erlotinib treatment and βIII-tubulin mRNA expression that of docetaxel, but histopathological diagnosis did not have any predictive value. Conclusions: Erlotinib and docetaxel show similar efficacy in the treatment of NSCLC. The application of predictive factors may facilitate qualification for second-line treatment with both drugs.

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“…[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The comparators in the analyses include docetaxel, pemetrexed and/or best supportive care. [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The comparators in the analyses include docetaxel, pemetrexed and/or best supportive care.…”

Section: Pharmacoeconomic Analyses Of Erlotinib In Advanced Nsclcmentioning

confidence: 99%

“…In the pivotal trials, median overall survival was 6.7 months (95% CI 5.5, 7.8) with erlotinib, [23] 7.5 (95% CI 5.5, 12.8), [45] 7.9 [46] and 5.7 (95% CI 5.1, 7.1) [47] months with docetaxel, and 8.3 months with pemetrexed [46] (95% CIs not reported in the JMEI trial). [40][41][42] Erlotinib lacks haematological toxicity and is associated with adverse events that are generally of mild to moderate severity (e.g. Docetaxel and, to a lesser extent, pemetrexed are associated with serious haematological adverse events (e.g.…”

Section: Pharmacoeconomic Analyses Of Erlotinib In Advanced Nsclcmentioning

confidence: 99%

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Erlotinib

Lyseng‐Williamson

2010

PharmacoEconomics

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Erlotinib (Tarceva), an oral epidermal growth factor receptor tyrosine kinase inhibitor, is associated with modest improvements in survival in patients with advanced non-small cell lung cancer (NSCLC) who have previously received one or more prior chemotherapy regimens. In a well designed clinical trial in this patient population, median overall survival and progression-free survival were significantly longer in patients receiving erlotinib 150 mg/day than in those receiving placebo. Erlotinib is generally well tolerated, with most adverse events being of mild to moderate severity. A large body of modelled pharmacoeconomic data suggests that second- or third-line erlotinib 150 mg/day is a cost-saving option relative to treatment with the approved second-line intravenous chemotherapies of docetaxel and pemetrexed in patients with advanced NSCLC. In patients who had received at least one prior chemotherapy regimen, erlotinib was predicted to be dominant (i.e. more effective and less costly) or cost saving (i.e. equally effective and less costly) relative to docetaxel or pemetrexed with regard to the cost per QALY or life-year gained in cost-effectiveness analyses. Although the effect of erlotinib on overall survival was generally assumed to be equivalent to that of the chemotherapies, the estimated amount of QALYs gained was slightly greater with erlotinib than with docetaxel. In cost-minimization and national budgetary impact analyses, estimated total direct costs with erlotinib were lower than those with docetaxel and pemetrexed, because of the generally lower drug acquisition, administration and adverse event management costs associated with erlotinib. Cost advantages with erlotinib were predicted across analyses, regardless of the type of model developed, specific costs that were included, country that the study was conducted in and year of costing. Sensitivity analyses consistently showed that these results were robust to plausible changes in the key model assumptions. In conclusion, in patients with advanced NSCLC, second- or third-line treatment with erlotinib is clinically effective in improving survival. Available pharmacoeconomic data from several countries, despite some inherent limitations, support the use of erlotinib as a cost-saving treatment relative to chemotherapy with docetaxel or pemetrexed in this patient population.

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A comparison of the estimated costs of erlotinib, docetaxel and pemetrexed for the second-line treatment of non-small cell lung cancer from the German healthcare perspective

Cited by 11 publications

References 10 publications

Cost-minimisation analysis of erlotinib in the second-line treatment of non-small-cell lung cancer: a Brazilian perspective

Cost-minimisation analysis of erlotinib in the second-line treatment of non-small-cell lung cancer: a Brazilian perspective

The Qualification of Docetaxel or Erlotinib for Second-Line Therapy Should Be Based on Clinical and Molecular Predictive Factors

Erlotinib

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