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

Stefani, Stephen; Saggia, Mario; Santos, E.A.V.

doi:10.3111/13696990802208186

Cited by 11 publications

(24 citation statements)

References 24 publications

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“…Although the results were very similar, they tended to favor erlotinib. Furthermore, when compared to best supportive care, docetaxel was a better option than erlotinib, as confirmed in other countries, such as Brazil 20. But NICE’s recommendations were less favorable from the point of view of the UK health care system 21.…”

Section: Resultsmentioning

confidence: 95%

Update on the treatment of non-small-cell lung cancer: focus on the cost-effectiveness of new agents

Vergnenègre¹,

Borget²,

Chouaïd³

2013

CEOR

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BackgroundThe incidence of lung cancer and the cost of drug treatment have increased dramatically in the last decade. This article examines the costs of new target agents, such as tyrosine kinase inhibitors (TKIs) and anti-angiogenic drugs.MethodsThis study uses PubMed research to focus on the topics of lung cancer, economics, and new targeted therapies.ResultsThe published papers only addressed TKIs and anti-angiogenic antibodies. For gefitinib, the results favored a clinical-based selection, despite the low number of studies. Erlotinib was studied in second line and as a maintenance treatment (with the studies reaching opposite conclusions in terms of cost-effectiveness). Economic analyses were not in favor of bevacizumab, but the studies on this topic were very heterogeneous.ConclusionThe economic impact of a drug depends on the health care system organization. Future clinical trials must include economic analyses, particularly with TKIs in the first line.

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Section: Resultsmentioning

confidence: 95%

Update on the treatment of non-small-cell lung cancer: focus on the cost-effectiveness of new agents

Vergnenègre¹,

Borget²,

Chouaïd³

2013

CEOR

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“…Results from these two papers are consistent -both concluded that the overall budget impact of adding erlotinib to the health plan was relatively small, with an increase around US$0.01 PMPM. One Brazilian study [22] included cost-minimization and budget impact analysis of erlotinib versus docetaxel or pemetrexed as second-line treatment for advanced NSCLC. The cost analysis showed that total costs were R$26,825 for erlotinib, R$42,284 for docetaxel and R$79,841 for pemetrexed; the budget impact analysis showed that cost savings associated with the use of erlotinib in the first year ranged from R$3 to R$28 million.…”

Section: Drug-specific Studies Erlotinibmentioning

confidence: 99%

A review of economic impact of targeted oral anticancer medications

Shen¹,

Chien²,

Geynisman³

et al. 2013

Expert Review of Pharmacoeconomics & Outcomes Research

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There has been a rapid increase in the use of targeted oral anticancer medications (OAMs) in the past decade. As OAMs are often expensive, economic consideration play a significant role in the decision to prescribe, receive or cover them. This paper performs a systematic review of costs or budgetary impact of targeted OAMs to better understand their economic impact on the healthcare system, patients as well as payers. We present our review in a summary table that describes the method and main findings, take into account multiple factors, such as country, analytical approach, cost type, study perspective, timeframe, data sources, study population and care setting when we interpret the results from different papers, and discuss the policy and clinical implications. Our review raises a concern regarding the role of sponsorship on findings of economic analyses as the vast majority of pharmaceutical company-sponsored studies reported cost advantages toward the sponsor's 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%

“…The BR.21 trial [23] (section 3) was the source of clinical data for oral erlotinib 150 mg/day. Some analyses [37,40,42] also incorporated data from the TAX 320 trial, [47] in which the efficacy of docetaxel was compared with that of a control regimen of vinorelbine or ifosfamide. Some analyses [37,40,42] also incorporated data from the TAX 320 trial, [47] in which the efficacy of docetaxel was compared with that of a control regimen of vinorelbine or ifosfamide.…”

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

Abstract: Erlotinib is cost-saving over established chemotherapy in the second-line treatment of advanced NSCLC under the Brazilian private healthcare system.

Cited by 11 publications

References 24 publications

Update on the treatment of non-small-cell lung cancer: focus on the cost-effectiveness of new agents

Update on the treatment of non-small-cell lung cancer: focus on the cost-effectiveness of new agents

A review of economic impact of targeted oral anticancer medications

Erlotinib

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