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

Loong, Herbert H.; Wong, Carlos King Ho; Leung, Louis M L; Chan, Catherine; Chang, Andrea; Zhou, Zheng–Yi; Xie, Jipan; Gibbs, Meaghan

doi:10.21203/rs.3.rs-17823/v1

Cited by 1 publication

(1 citation statement)

References 26 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study is the first to evaluate the cost-effectiveness of atezolizumab versus BSC as an adjuvant treatment strategy after postoperative platinum-based chemotherapy for early-stage NSCLC (PD-L1 TC ≥ 1% stage II -IIIA group, all stage II -IIIA groups, or the intention-to-treat group (stage IB -IIIA)) from the perspective of the Chinese health care system, Unlike studies using proportional hazards models (44,45), parametric curves in this study were fitted to each treatment group separately (46,47), and the reason for the crossover of the PFS curves may be due to the fact that atezolizumab showed a pretreatment advantage of different groups at different times.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of adjuvant therapy with atezolizumab in Chinese patients with stage IB-IIIA resectable NSCLC after adjuvant chemotherapy

Chen

Yang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundAtezolizumab was first shown to significantly improve progression-free survival (PFS) after platinum-based chemotherapy in early-stage non-small cell lung cancer (NSCLC) in the IMpower010 Phase 3 trial. However, the cost-effectiveness and potential economic impact of atezolizumab treatment in Chinese patients are unknown.MethodsMarkov models were constructed based on follow-up data from the IMpower010 trial and assessed separately in the programmed cell death receptor ligand-1 (PD-L1) tumor cells (TC) ≥ 1% stage II – IIIA group, all stage II – IIIA groups, and the intention-to-treat (ITT) group (stage IB–IIIA). Efficacy and safety data were obtained from the IMpower010 trial, and costs and utility values were derived from the literature and local surveys to estimate their incremental cost-effectiveness ratios (ICERs) compared with willingness-to-pay (WTP) thresholds in scenarios implementing patient assistance programs (PAP) or drug price negotiations. Univariate sensitivity analysis and probabilistic sensitivity analysis (PSA) were performed to investigate the stability of the model results.ResultsCompared with best supportive care (BSC), atezolizumab produced an additional 0.45 quality-adjusted life-years (QALYs), 0.04 QALYs, and -0.0028 QALYs in the PD-L1 TC ≥ 1% stage II – IIIA group, all stage II – IIIA groups, and the ITT group, and the ICERs were 108,825.37/QALY, 1,028,538.22/QALY, and -14,381,171.55/QALY, respectively. The ICERs all exceeded the WTP threshold of $27,354 per QALY (three times the per capita gross domestic product of China in 2022), and univariate sensitivity analysis showed that the price of atezolizumab played a crucial role in the model results. PSA showed that the probability of cost-effectiveness of atezolizumab in the PD-L1 TC ≥ 1% stage II – IIIA group, all stage II – IIIA groups, and the ITT group increased with the increasing WTP threshold.ConclusionFrom the perspective of China’s health care system, in the PD-L1 TC ≥ 1% stage II – IIIA group, all stage II – IIIA groups, and the ITT group, the use of atezolizumab in the adjuvant treatment of patients with early-stage NSCLC after platinum-based chemotherapy is unlikely to be cost-effective. The implementation of PAP or price reduction negotiations for atezolizumab might be among the most effective measures to improve its cost-effectiveness.

show abstract

Section: Discussionmentioning

confidence: 99%