PCN136 Cost-Effectiveness Analysis of Dacomitinib Versus Gefitinib for the First-line Treatment of Locally Advanced or Metastatic Non-Small Cell Lung Cancer with Epidermal Growth Factor Receptor (EGFR)-Activating Mutations in Portugal

Miguel, L Silva; Paquete, A.T.; Alarcão, Joana; Guerreiro, Rita; María, Isabel; Borges, Margarida

doi:10.1016/j.jval.2020.08.273

Cited by 3 publications

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“…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 , ...…”

Section: Resultsmentioning

confidence: 99%

“…3 ). 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 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most were cost-utility analyses ( n = 52) [ 30 – 32 , 34 – 44 , 46 – 50 , 52 , 53 , 55 – 79 , 81 – 95 ], four were cost-effectiveness analyses [ 33 , 45 , 51 , 54 ], one was a cost-minimization analysis [ 80 ], and two (both of which were HTA submissions) presented both a cost-utility and cost-minimization analysis depending on the comparator [ 76 , 81 ]. The choice of model type was only reported in two studies that used a cost-minimization analysis, to justify that model type, given there were no statistically significant differences in efficacy and safety between treatment options [ 80 , 81 ].…”

Section: Resultsmentioning

confidence: 99%

“…Progressive disease 3. Death NR 20 years 5.0% NR Miguel et al, 2020 [ 52 ] PSM Probabilistic 1. Progression-free 2.…”

Section: Resultsmentioning

confidence: 99%

“…Fifty-six of the 59 studies were deterministic [ 30 – 44 , 46 – 50 , 52 , 53 , 55 – 88 ] and three studies did not report structure type [ 45 , 51 , 54 ]. A similar number of studies used a Markov model ( n = 20) [ 30 , 33 , 38 , 40 , 41 , 47 , 50 , 57 – 62 , 65 , 68 , 71 , 75 , 77 , 81 , 84 ] or a partitioned survival model ( n = 22) [ 31 , 32 , 34 , 36 , 42 – 44 , 46 , 52 , 53 , 56 , 67 , 69 , 70 , 72 , 73 , 78 , 82 , 83 , 86 – 88 ].…”

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 20 years 5.0% NR Miguel et al, 2020 [ 52 ] PSM Probabilistic 1. Progression-free 2.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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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The cost-effectiveness of dacomitinib in first-line treatment of advanced/metastatic epidermal growth factor receptor mutation-positive non-small-cell lung cancer (EGFRm NSCLC) in Sweden

Nilsson

Gál²,

Houisse³

et al. 2021

Journal of Medical Economics

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Aims: Although the benefit of first-line epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) over chemotherapy in EGFR mutation-positive (EGFRm) non-smallcell lung cancer (NSCLC) has been demonstrated in clinical trials, the optimal treatment sequence remains unclear. The objective of our study was to evaluate the cost-effectiveness of dacomitinib in Sweden versus afatinib and osimertinib in first-line treatment of EGFRm NSCLC. Materials and methods: A partitioned survival model was developed with three health states: progression-free, post-progression, and death. Progression-free and overall survival curves were used to inform movements between states. Clinical data were taken from randomized trials, compared via a network meta-analysis (NMA). Utility data were taken from published studies and costs from national Swedish sources. The model used a 15-year time horizon and a Swedish healthcare payer perspective. Sensitivity and scenario analyses were performed. Results: The base-case analysis showed that dacomitinib accrued a total of 2.10 qualityadjusted life years (QALYs) at a total cost of Swedish krona (SEK) 874,615. The incremental cost-effectiveness ratio (ICER) for dacomitinib versus afatinib was SEK 461,556 per QALY gained. The ICER of osimertinib versus dacomitinib, where the small QALY gains of the former came at a high additional cost, was SEK 11,444,709. Deterministic and probabilistic sensitivity analyses confirmed robustness of these results; changes to drug and medical resource use costs and overall survival had the greatest impact on ICER estimates. Limitations: This model is subject to uncertainty associated with extrapolating long-term A c c e p t e d M a n u s c r i p t treatment effects from shorter trial follow-up periods, although this would also be a limitation when using direct comparison or time-dependent hazard ratios. The NMA was limited by the use of indirect comparison although sensitivity analyses supported the robustness of our findings. Conclusions: Our model demonstrated dacomitinib is cost-effective for first-line EGFRm NSCLC treatment in Sweden versus afatinib and osimertinib.

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Cost-effectiveness analysis of the first‐line EGFR‐TKIs in patients with advanced EGFR-mutated non-small-cell lung cancer

Aguilar-Serra

Gimeno‐Ballester

Pastor-Clerigues

et al. 2021

Expert Review of Pharmacoeconomics & Outcomes Research

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PCN136 Cost-Effectiveness Analysis of Dacomitinib Versus Gefitinib for the First-line Treatment of Locally Advanced or Metastatic Non-Small Cell Lung Cancer with Epidermal Growth Factor Receptor (EGFR)-Activating Mutations in Portugal

Cited by 3 publications

References 0 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

The cost-effectiveness of dacomitinib in first-line treatment of advanced/metastatic epidermal growth factor receptor mutation-positive non-small-cell lung cancer (EGFRm NSCLC) in Sweden

Cost-effectiveness analysis of the first‐line EGFR‐TKIs in patients with advanced EGFR-mutated non-small-cell lung cancer

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