Dacomitinib in first-line treatment of advanced EGFR-mutated non-small-cell lung cancer: a cost–effectiveness analysis

Abstract

Aim: To assess the cost–effectiveness of first-line treatment with dacomitinib compared with gefitinib in patients newly diagnosed with advanced NSCLC EGFR-positive in the context of Spain. Materials & methods: A partitioned survival model was developed including costs, utilities and disutilities to estimate quality-adjusted life-year (QALY) and incremental cost–effectiveness ratio when treating with dacomitinib versus gefitinib. Results: Dacomitinib presented higher QALYs (0.51) compared with gefitinib (0.45). Dacomitinib costs were €33,061 in comparison with €26,692 for gefitinib arm. An incremental cost–effectiveness ratio of €111,048 was obtained for dacomitinib. Conclusion: Dacomitinib was more effective in terms of QALYs gained than gefitinib. However, to obtain a cost–effectiveness alternative, a discount greater than 25% in dacomitinib acquisition cost is required.

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

“…All 59 studies included an EGFR TKI as an intervention; this was considered appropriate given the focus of the identified studies in patients harboring an EGFR mutation. The most frequently evaluated interventions were osimertinib ( n = 18) [ 30 , 32 , 34 , 35 , 38 , 40 , 44 , 47 , 50 , 51 , 55 , 62 , 68 , 71 , 73 , 78 , 83 , 88 ], dacomitinib ( n = 14) [ 31 , 32 , 40 , 42 , 43 , 47 , 52 , 53 , 63 , 67 , 72 , 74 , 82 , 87 ], afatinib ( n = 17) [ 32 , 33 , 36 , 39 , 40 , 45 , 46 , 56 , 57 , 59 , 65 , 66 , 69 , 70 , 77 , 80 , 86 ], gefitinib ( n = 12) [ 33 , 37 , 40 , 41 , 49 , 50 , 54 , 65 , 69 , 75 , 81 , 84 ], and erlotinib ( n = 12) [ 32 , 40 , 50 , ...…”

“…Twenty-eight studies did not state the rationale for the choice of comparator [ 30 , 33 , 35 , 36 , 38 , 39 , 41 – 43 , 45 , 46 , 48 , 52 , 54 , 56 – 63 , 65 – 68 , 72 , 76 ]. In the remaining 31 studies, comparators were selected to reflect standard of care, which was defined as commonly used regimens or licensed treatment [ 31 , 32 , 34 , 37 , 40 , 44 , 47 , 49 – 51 , 53 , 55 , 64 , 69 – 71 , 73 – 75 , 77 – 88 ]. Only one of these studies also included comparator regimens that were investigational in order to provide a comprehensive picture of possible treatment options [ 40 ].…”

“…Progressive disease 3. Death NR 10 years 5.0% (costs only) 1 month Aguilar-Serra et al, 2021 [ 31 ] PSM Probabilistic 1. Stable disease 2.…”

Bioequivalence study of dacomitinib and Vizimpro® in healthy Chinese volunteers under fasting and fed conditions: A randomized, open‐label, single‐dose, crossover trial

“…It is well known that original drugs are too expensive for most patients with cancer 21 ; thus, generic drugs provide the maximum accessibility of treatments for patients, relieve the social economic burden. T max (h) 6.00 (4.5, 10) 6.00 (4.…”

“…The median T max of the two formulations under fasting conditions were 6.0 h (range: 4.5–10 h) and 6.0 h (range: 4.5–48 h), respectively, and under fed conditions were both 5.00 h (range: 4.5–12 h), which were similar to the range of approximately 6 h (2–24 h) demonstrated in previous studies 17 . We set the washout period at 21 days according to the mean t 1/2 of ~70 h, which was more than seven times the t 1/2 to fulfil regulatory requirements 21 . The mean AUC _%Extrap for the test and reference formulations under fasting and fed conditions were all <20%, indicating that the sampling time (240 h) was long enough to ensure absorption.…”