Cost-effectiveness of ceritinib in patients previously treated with crizotinib in anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer in Canada

Hurry, M.; Zhou, Zheng–Yi; Zhang, Jie; Zhang, Chenxue; Fan, Lifeng; Rebeira, Mayvis; Xie, Jipan

doi:10.1080/13696998.2016.1187151

Cited by 16 publications

(5 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study nding is not consistent with previous studies. The Canadian study found ceritinib to be costeffective among patients who have progressed or are intolerant to crizotinib, comparing with the willingness-to-pay threshold for end-of-life cancer drugs 10 . This result may not be comparable because of the heterogeneity in study samples, drug costs, parameters, and willingness-to-pay threshold.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have evaluated the cost-effectiveness of ceritinib. One study has speci cally evaluated its cost-effectiveness as a following treatment among patients previously treated with crizotinib in Canadian patients 10 . It suggested that ceritinib is a cost-effective option compared with other alternatives in patients who have progressed or are intolerant to crizotinib in Canada, based on the willingness-to-pay threshold for end-of-life cancer drugs.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Cost effectiveness of ceritinib in patients previously treated with crizotinib and chemotherapy with anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC) in the United States

Zhang

Shao

Stoecker

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundLung cancer is the leading cause of cancer death in the United States. Among non-small cell lung cancer (NSCLC) patients with anaplastic lymphoma kinase mutation (ALK+) and who were resistant to crizotinib, ceritinib was approved as a following treatment. Ceritinib was found to be cost effective among Canadian patients, but its cost effectiveness among US population remains unknown.ObjectiveTo evaluate the cost-effectiveness of ceritinib versus chemotherapy among ALK+ NSCLC patients who received treatment of crizotinib and chemotherapy, from the US healthcare perspective.MethodsA Markov model with three health states (progression-free, progression, and death) and a partitioned survival analysis model (PartSA) were developed, respectively. Survival functions, including progression free survival and overall survival, for ceritinib and chemotherapy were extrapolated from clinical trials ASCEND-2, ASCEND-5, and PROFILE-1007. Costs for the drugs, monitoring, and adverse events, and utilities at each health state were derived from published literature. Costs were inflated to 2018 US dollars. An annual discount rate of 3% was applied to costs and utilities, and a 5-year time horizon was applied to the analysis. Incremental cost per quality-adjusted life year (QALY) gained for ceritinib versus chemotherapy was estimated with $150,000/QALY as the US willingness-to-pay threshold. Sensitivity analyses (i.e., one-way sensitivity analysis and probabilistic sensitivity analysis) were conducted to test the uncertainties of the models.ResultsBoth models find ceritinib yields fewer QALYs than chemotherapy. The Markov model indicates modest cost-savings of ceritinib when compared to chemotherapy (-$3,131) and small declines in health (-1.04 QALYs) ($3008.39 per QALY lost). The PartSA model indicates additional costs of ceritinib when compared to chemotherapy ($12,884.95) and similar declines in health (-0.87 QALYs), indicating a dominated strategy. Both models were most sensitive to parameters of medical cost for progression disease and cost of ceritinib.ConclusionsCeritinib is not cost effective compared to chemotherapy among patients who were previously treated with crizotinib and chemotherapy, from the US healthcare perspective.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Cost effectiveness of ceritinib in patients previously treated with crizotinib and chemotherapy with anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC) in the United States

Zhang

Shao

Stoecker

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Prior cost-effectiveness studies comparing ceritinib to crizotinib in patients with ALK+ NSCLC have largely focused on previously treated patients. [33][34][35][36] One study in the US that examined the costeffectiveness of ceritinib compared to crizotinib in previously untreated patients with ALK+ NSCLC based on efficacy using indirect treatment comparison, showed ceritinib to be a more cost-effective treatment option than crizotinib in first line, both in short and long term. 37 However, differences exist in the healthcare systems between the US, UK and HK populations, which may translate into different resource utilization and disease management.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of ceritinib in previously untreated anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) in Hong Kong

Loong

Wong

Leung

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Lower-dose ceritinib (450mg) once-daily with food was approved in 2018 in Hong Kong (HK) for first-line treatment of patients with anaplastic lymphoma kinase-positive (ALK+) advanced non-small cell lung cancer (NSCLC). This study examined the cost-effectiveness of ceritinib vs. crizotinib in the first-line treatment of ALK+ NSCLC from a HK healthcare service provider's or government's perspective.Methods: Costs and effectiveness of first-line ceritinib vs. crizotinib over a 20-year time horizon was evaluated using a partitioned survival model with three health states (stable disease, progressed disease, and death). The efficacy data for ceritinib were obtained from ASCEND-4 and extrapolated using parametric survival models. Long-term survival associated with crizotinib were estimated using hazard ratio of crizotinib vs. ceritinib obtained from matching-adjusted indirect comparison based on ASCEND-4 and PROFILE 1014 trials. Drug acquisition, administration, adverse events costs, and medical costs associated with each health state were obtained from public sources and converted to 2018 US Dollars. Incremental costs per quality-adjusted-life-year (QALY) and life-year (LY) gained were estimated for ceritinib vs. crizotinib.Results: The base case results showed that ceritinib was associated with 3.22 QALYs, 4.51 LYs, and total costs of $157,581 over 20 years. Patients receiving crizotinib had 2.68 QALYs, 3.85 LYs, and $150,424 total costs over the same time horizon. The incremental cost per QALY gained for ceritinib vs crizotinib was $13,343. Results were robust to deterministic sensitivity analyses in most scenarios.Conclusion: Ceritinib offers a cost-effective option compared to crizotinib for previously untreated ALK+ advanced NSCLC in HK.New knowledge added by this study• In order to optimize patient outcomes and effectively allocate healthcare resources, rigorous economic evaluations are needed to inform reimbursement decision-making regarding the cost-effectiveness of available therapies.• With ceritinib's recent introduction as a first-line targeted therapy, these results provide important insight for decision-makers considering treatments for ALK+ advanced NSCLC in Hong Kong.Implication for clinical practice or policy• Ceritinib offers a cost-effective option compared to crizotinib for previously untreated ALK+ advanced NCSLC in HK with an incremental cost per QALY of $13,343 USD, which is significantly lower than the willingness to pay threshold in Hong Kong.• In previously untreated adult patients with ALK+ advanced NCSLC, ceritinib is predicted to offer marked benefits in PFS, LYs, and QALYs compared to crizotinib.• Ceritinib offers a valuable treatment option for front-line treatment of patients with ALK+ advanced NCSLC in HK.

show abstract

“…Prior cost-effectiveness studies comparing ceritinib to crizotinib in patients with ALK+ NSCLC have largely focused on previously treated patients. [35][36][37][38] One study in the US that examined the costeffectiveness of ceritinib compared to crizotinib in previously untreated patients with ALK+ NSCLC based on e cacy using indirect treatment comparison. The incremental cost per QALY gained was $66,064 for ceritinib versus crizotinib, showing ceritinib to be a more cost-effective treatment option in rst line.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of ceritinib vs. crizotinib in previously untreated anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) in Hong Kong

Loong

Wong

Leung

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Introduction: Lower-dose ceritinib (450mg) once-daily with food was approved in 2018 in Hong Kong (HK) for first-line treatment of patients with anaplastic lymphoma kinase-positive (ALK+) advanced non-small cell lung cancer (NSCLC). This study examined the cost-effectiveness of ceritinib vs. crizotinib in the first-line treatment of ALK+ NSCLC from a HK healthcare service provider's or government's perspective. Methods: Costs and effectiveness of first-line ceritinib vs. crizotinib over a 20-year time horizon was evaluated using a partitioned survival model with three health states (stable disease, progressed disease, and death). The efficacy data for ceritinib were obtained from a phase 3 trial comparing ceritinib with chemotherapy for advanced non-small cell lung cancer (ASCEND-4) and extrapolated using parametric survival models. Long-term survival associated with crizotinib were estimated using hazard ratio of crizotinib vs. ceritinib obtained from matching-adjusted indirect comparison based on ASCEND-4 and PROFILE 1014 trials. Drug acquisition, administration, adverse events costs, and medical costs associated with each health state were obtained from public sources and converted to 2018 US Dollars. Incremental costs per quality-adjusted-life-year (QALY) and life-year (LY) gained were estimated for ceritinib vs. crizotinib. Results: The base case results showed that ceritinib was associated with 3.22 QALYs, 4.51 LYs, and total costs of $157,581 over 20 years. Patients receiving crizotinib had 2.68 QALYs, 3.85 LYs, and $150,424 total costs over the same time horizon. The incremental cost per QALY gained for ceritinib vs crizotinib was $13,343. Results were robust to deterministic sensitivity analyses in most scenarios. Conclusion: Ceritinib offers a cost-effective option compared to crizotinib for previously untreated ALK+ advanced NCSLC in HK.

show abstract

Cost-effectiveness of ceritinib in patients previously treated with crizotinib in anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer in Canada

Abstract: Based on the willingness-to-pay threshold for end-of-life cancer drugs, ceritinib may be considered as a cost-effective option compared with other alternatives in patients who have progressed or are intolerant to crizotinib in Canada.

Cited by 16 publications

References 21 publications

Cost effectiveness of ceritinib in patients previously treated with crizotinib and chemotherapy with anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC) in the United States

Cost effectiveness of ceritinib in patients previously treated with crizotinib and chemotherapy with anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC) in the United States

Cost-effectiveness of ceritinib in previously untreated anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) in Hong Kong

Cost-effectiveness analysis of ceritinib vs. crizotinib in previously untreated anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) in Hong Kong

Contact Info

Product

Resources

About