Cost-Effectiveness Analysis of Gefitinib Alone and Combined with Chemotherapy as First-Line Treatment for Patients with Advanced Non-Small-Cell Lung Cancer

Wang, Yao; Huang, Kaiyu; Sun, Sijia; Deng, Yong; Xie, Xuefeng

doi:10.2147/rmhp.s352827

Cited by 3 publications

(10 citation statements)

References 26 publications

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“…Eighteen studies explicitly described the intended audience [ 30 – 32 , 39 , 49 , 50 , 55 – 57 , 59 – 61 , 66 , 84 – 88 ]. Among these studies, 13 categorized the audience as a medical/clinical decision maker [ 30 – 32 , 39 , 49 , 50 , 55 – 57 , 59 – 61 , 66 ] and five were NICE submission documents that specified the audience as ‘[NICE] consultees and commentators’ [ 84 – 88 ]. The results of the economic evaluations were used to directly support decisions regarding reimbursement via HTA documents ( n = 20) [ 69 – 88 ].…”

Section: Resultsmentioning

confidence: 99%

“…The results of the economic evaluations were used to directly support decisions regarding reimbursement via HTA documents ( n = 20) [ 69 – 88 ]. For the remainder, studies stated that the use was for policy/funding decisions ( n = 5) [ 34 , 35 , 48 , 56 , 62 ], to promote the sustainability of limited healthcare resources ( n = 5) [ 30 – 32 , 60 , 61 ], or to support treatment choices ( n = 7) [ 39 , 47 , 50 , 55 , 57 , 59 , 65 ]. Twenty-two studies did not explicitly state the intended use of the economic evaluations [ 33 , 36 – 38 , 40 – 46 , 49 , 51 – 54 , 58 , 63 , 64 , 66 – 68 ].…”

Section: Resultsmentioning

confidence: 99%

“…The most common comparators among the 59 studies reporting on an economic evaluation in locally advanced NSCLC patients harboring an EGFR mutation were EGFR TKIs ( n = 35) [ 30 – 32 , 34 – 36 , 38 , 41 – 45 , 48 , 51 – 55 , 59 , 61 , 63 , 67 , 68 , 71 – 74 , 78 , 80 , 82 , 83 , 85 – 88 ], platinum-based chemotherapy ( n = 12) [ 49 , 56 , 58 , 60 , 65 , 66 , 75 – 77 , 79 , 81 , 84 ], or either EGFR TKIs or platinum-based chemotherapies evaluated in the same model ( n = 5) [ 37 , 39 , 57 , 62 , 70 ]. Seven studies did not distinguish a reference comparator but evaluated multiple first-line treatments [ 33 , 40 , 46 , 47 , 50 , 64 , 69 ].…”

Section: Resultsmentioning

confidence: 99%

“…Progressive disease 3. Death NR 15 years 3.0% 28 days Wang et al, 2022 [ 61 ] Markov model Probabilistic 1. Progression-free 2.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of the 59 studies ( n = 46) [ 30 – 37 , 39 – 41 , 44 , 46 – 50 , 52 , 53 , 55 – 61 , 63 , 65 – 70 , 72 – 74 , 76 – 79 , 82 , 83 , 85 – 88 ] employed a three-health state model consisting of progression-free, progressive disease, and death. An additional three studies used a four-health state model including response, stable disease, disease progression and death (two of which were HTA submissions for gefitinib to NICE [ 84 ] and the Scottish Medicines Consortium [SMC] [ 81 ], and one for osimertinib for the CADTH [ 71 ]).…”

Section: Resultsmentioning

confidence: 99%

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Critical Examination of Modeling Approaches Used in Economic Evaluations of First-Line Treatments for Locally Advanced or Metastatic Non-Small Cell Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations: A Systematic Literature Review

Raad,

Rizzo,

Appiah

et al. 2024

PharmacoEconomics

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Background Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, with up to 32% of patients with NSCLC harboring an epidermal growth factor receptor (EGFR) mutation. NSCLC harboring an EGFR mutation has a dedicated treatment pathway, with EGFR tyrosine kinase inhibitors and platinum-based chemotherapy often being the therapy of choice. Objective The aim of this study was to systemically review and summarize economic models of first-line treatments used for locally advanced or metastatic NSCLC harboring EGFR mutations, as well as to identify areas for improvement for future models. Methods Literature searches were conducted via Ovid in PubMed, MEDLINE, MEDLINE In-Process, Embase, Evidence-Based Medicine Reviews: Health Technology Assessment, Evidence-Based Medicine Reviews: National Health Service Economic Evaluation Database, and EconLit. An initial search was conducted on 19 December 2022 and updated on 11 April 2023. Studies were selected according to predefined criteria using the Population, Intervention, Comparator, Outcome and Study design (PICOS) framework. Results Sixty-seven articles were included in the review, representing 59 unique studies. The majority of included models were cost-utility analyses ( n = 52), with the remaining studies being cost-effectiveness analyses ( n = 4) and a cost-minimization analysis ( n = 1). Two studies incorporated both a cost-utility and cost-minimization analysis. Although the model structure across studies was consistently reported, justification for this choice was often lacking. Conclusions Although the reporting of economic models in NSCLC harboring EGFR mutations is generally good, many of these studies lacked sufficient reporting of justification for structural choices, performing extensive sensitivity analyses and validation in economic evaluations. In resolving such gaps, the validity of future models can be increased to guide healthcare decision making in rare indications. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-024-01362-2.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Progressive disease 3. Death NR 15 years 3.0% 28 days Wang et al, 2022 [ 61 ] Markov model Probabilistic 1. Progression-free 2.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Critical Examination of Modeling Approaches Used in Economic Evaluations of First-Line Treatments for Locally Advanced or Metastatic Non-Small Cell Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations: A Systematic Literature Review

Raad,

Rizzo,

Appiah

et al. 2024

PharmacoEconomics

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Cost-Effectiveness Analysis of Tislelizumab Plus Chemotherapy as First-Line Treatment for Advanced or Metastatic Esophageal Squamous Cell Carcinoma in China

Zhou,

Wei,

et al. 2023

RMHP

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Background: Tislelizumab plus chemotherapy improved overall survival compared to chemotherapy alone, while maintaining an acceptable level of safety. But it's still unclear which strategy is the most cost-effective. The objective of the study was to compare the cost-effectiveness of tislelizumab plus chemotherapy as first-line therapy for patients with advanced or metastatic esophageal squamous cell carcinoma (ESCC) versus chemotherapy alone. Methods: A partitioned survival model with three states was constructed based on the RATIONALE-306 trial. The model's time horizon was ten years, and its cycle was three weeks. Only direct medical costs were considered from the healthcare perspective in China. Calculations were performed on total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). One-way sensitivity and probabilistic sensitivity analysis (PSA) were performed to determine the uncertainty regarding model parameters. Results: Tislelizumab plus chemotherapy provided 1.35 QALYs for $26,450.77, while chemotherapy alone provided 0.89 QALY for $16,687.15. Compared to chemotherapy alone, tislelizumab had an ICER of $21,062.09/QALY. At the threshold of three times the Chinese GDP per capita ($38,253/QALY), the PSA indicated that tislelizumab had a 96.4% likelihood of being designated costeffective. At the threshold of 1.5 times the Chinese GDP per capita ($19,126.5/QALY), the PSA indicated that tislelizumab had a probability of 48.7% of being designated cost-effective. Conclusion: Tislelizumab plus chemotherapy as the first treatment for patients with advanced or metastatic ESCC may be a costeffective option compared to chemotherapy alone at 3 times Chinese GDP per capita.

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Cost-effectiveness of sotorasib as a second-line treatment for non-small cell lung cancer with KRASG12C mutation in China and the United States

Zhu,

Tang,

Sun

et al. 2024

Front. Pharmacol.

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PurposeTo evaluate the cost-effectiveness of sotorasib versus docetaxel in non-small cell lung cancer (NSCLC) patients with KRASG12C mutation from the China and United States’social perspective.Materials and MethodsA Markov model that included three states (progression-free survival, post-progression survival, and death) was developed. Incremental cost-effectiveness ratio (ICER), quality-adjusted life-year (QALY), and incremental QALY were calculated for the two treatment strategies. One-way sensitivity analysis was used to investigate the factors that had a greater impact on the model results, and tornado diagrams were used to present the results. Probabilistic sensitivity analysis was performed with 1,000 Monte Carlo simulations. Assume distributions based on parameter types and randomly sample all parameter distributions each time., The results were presented as cost-effectiveness acceptable curves.ResultsThis economic evaluation of data from the CodeBreak 200 randomized clinical trial. In China, sotorasib generated 0.44 QAYL with a total cost of $84372.59. Compared with docetaxel, the ICER value of sotorasib was $102701.84/QALY, which was higher than willingness to pay (WTP), so sotorasib had no economic advantage. In the US, sotorasib obtained 0.35 QALY more than docetaxel, ICER was $15,976.50/QALY, which was more than 1 WTP but less than 3 WTP, indicating that the increased cost of sotorasib was acceptable. One-way sensitivity analysis showed that the probability of sotorasib having economic benefits gradually increased when the cost of follow-up examination was reduced in China. And there was no influence on the conclusions within the range of changes in China. When the willingness to pay (WTP) exceeds $102,500, the probability of sotorasib having cost effect increases from 0% to 49%.ConclusionSotorasib had a cost effect from the perspective in the United States. However, sotorasib had no cost effect from the perspective in China, and only when the WTP exceeds $102,500, the probability of sotorasib having cost effect increases from 0% to 49%.

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Cost-Effectiveness Analysis of Gefitinib Alone and Combined with Chemotherapy as First-Line Treatment for Patients with Advanced Non-Small-Cell Lung Cancer

Cited by 3 publications

References 26 publications

Critical Examination of Modeling Approaches Used in Economic Evaluations of First-Line Treatments for Locally Advanced or Metastatic Non-Small Cell Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations: A Systematic Literature Review

Critical Examination of Modeling Approaches Used in Economic Evaluations of First-Line Treatments for Locally Advanced or Metastatic Non-Small Cell Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations: A Systematic Literature Review

Cost-Effectiveness Analysis of Tislelizumab Plus Chemotherapy as First-Line Treatment for Advanced or Metastatic Esophageal Squamous Cell Carcinoma in China

Cost-effectiveness of sotorasib as a second-line treatment for non-small cell lung cancer with KRASG12C mutation in China and the United States

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