Pcn20 Maintenance Erlotinib Versus Pemetrexed for the Treatment of Non-Small Cell Lung Cancer: Indirect Comparison Applying Real-Life Outcomes

Casciano, Roman; Bischoff, Helge; Nuijten, MJ; Malangone, Elisabetta; Ray, Joshua

doi:10.1016/s1098-3015(11)71917-9

Cited by 4 publications

(6 citation statements)

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“…In a population-matched, indirect comparison analysis comparing erlotinib and pemetrexed as first-line maintenance therapy in metastatic NSCLC, both treatments were found to be similarly efficacious ( Table 3 ). 23 An economic analysis of pemetrexed versus best supportive care in the US market showed that the cost per life-year gained using pemetrexed first-line maintenance therapy versus best supportive care in patients with advanced, non-squamous NSCLC was US$122,371 (€86,869). 22 The analysis suggests that pemetrexed is not cost-effective compared with best supportive care, given the cost-effectiveness ratios for medication typically reimbursed in the US, while our analysis shows that erlotinib is cost-effective when compared with best supportive care ( Table 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…If a cost-effectiveness analysis of erlotinib versus pemetrexed were to be performed, the comparable efficacy of erlotinib and pemetrexed derived from the indirect comparison analysis 23 would make drug costs the key driver. Monthly costs of erlotinib and pemetrexed comprising administration, acquisition, and adverse event costs ( Table 3 ) derived from a manuscript in press 28 (published in part at a recent scientific conference 24 , 25 ) show erlotinib has lower monthly per-patient treatment costs.…”

Section: Discussionmentioning

confidence: 99%

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Cross-market cost-effectiveness analysis of erlotinib as first-line maintenance treatment for patients with stable non-small cell lung cancer

Vergnenègre

Ray

Chouaïd³

et al. 2012

CEOR

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BackgroundPlatinum-doublet, first-line treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) is limited to 4–6 cycles. An alternative strategy used to prolong the duration of first-line treatment and extend survival in metastatic NSCLC is first-line maintenance therapy. Erlotinib was approved for first-line maintenance in a stable disease population following results from a randomized, controlled Phase III trial comparing erlotinib with best supportive care. We aimed to estimate the incremental cost-effectiveness of erlotinib 150 mg/day versus best supportive care when used as first-line maintenance therapy for patients with locally advanced or metastatic NSCLC and stable disease.MethodsAn economic decision model was developed using patient-level data for progression-free survival and overall survival from the SATURN (SequentiAl Tarceva in UnResectable NSCLC) study. An area under the curve model was developed; all patients entered the model in the progression-free survival health state and, after each month, moved to progression or death. A time horizon of 5 years was used. The model was conducted from the perspective of national health care payers in France, Germany, and Italy. Probabilistic sensitivity analyses were performed.ResultsTreatment with erlotinib in first-line maintenance resulted in a mean life expectancy of 1.39 years in all countries, compared with a mean 1.11 years with best supportive care, which represents 0.28 life-years (3.4 life-months) gained with erlotinib versus best supportive care. In the base-case analysis, the cost per life-year gained was €39,783, €46,931, and €27,885 in France, Germany, and Italy, respectively.ConclusionErlotinib is a cost-effective treatment option when used as first-line maintenance therapy for locally advanced or metastatic NSCLC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cross-market cost-effectiveness analysis of erlotinib as first-line maintenance treatment for patients with stable non-small cell lung cancer

Vergnenègre

Ray

Chouaïd³

et al. 2012

CEOR

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show abstract

Section: Discussionmentioning

confidence: 99%

“…A recent population-matched indirect comparison of erlotinib and pemetrexed considering the intention-to-treat population of the SATURN and JMEN trials has found both treatments to be similarly efficacious. 19 In addition, Nuijten et al have demonstrated that erlotinib is less costly than pemetrexed. 20 Further considering other demonstrated advantages of erlotinib in terms of tolerability, administration, and patient convenience, 19 erlotinib appears to be the preferred treatment option over pemetrexed.…”

Section: Discussionmentioning

confidence: 99%

Maintenance erlotinib in advanced nonsmall cell lung cancer: cost-effectiveness in EGFR wild-type across Europe

Walleser¹,

Ray²,

Bischoff³

et al. 2012

CEOR

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BackgroundFirst-line maintenance erlotinib in patients with locally advanced or metastatic nonsmall cell lung cancer (NSCLC) has demonstrated significant overall survival and progression-free survival benefits compared with best supportive care plus placebo, irrespective of epidermal growth factor receptor (EGFR) status (SATURN trial). The cost-effectiveness of first-line maintenance erlotinib in the overall SATURN population has been assessed and published recently, but analyses according to EGFR mutation status have not been performed yet, which was the rationale for assessing the cost-effectiveness of first-line maintenance erlotinib specifically in EGFR wild-type metastatic NSCLC.MethodsThe incremental cost per life-year gained of first-line maintenance erlotinib compared with best supportive care in patients with EGFR wild-type stable metastatic NSCLC was assessed for five European countries (the United Kingdom, Germany, France, Spain, and Italy) with an area-under-the-curve model consisting of three health states (progression-free survival, progressive disease, death). Log-logistic survival functions were fitted to Phase III patient-level data (SATURN) to model progression-free survival and overall survival. The first-line maintenance erlotinib therapy cost (modeled for time to treatment cessation), medication cost in later lines, and cost for the treatment of adverse events were included. Deterministic and probabilistic sensitivity analyses using Monte Carlo simulation (1000 iterations) were performed.ResultsAccording to the model simulations, first-line maintenance erlotinib compared with best supportive care in EGFR wild-type stable metastatic NSCLC resulted in 4.57 months of life gained (17.82 months for erlotinib versus 13.24 months for best supportive care) and 1.14 months of life without progression gained (erlotinib 4.29 versus best supportive care 3.15), and incremental total costs of erlotinib from €7897 (UK) to €9580 (Germany). The corresponding mean incremental cost per life-year gained of erlotinib ranged between €20,711 (UK) and €25,124 (Germany). Sensitivity analyses confirmed these results.ConclusionFirst-line erlotinib maintenance treatment is cost-effective compared with best supportive care in EGFR wild-type stable metastatic NSCLC, irrespective of the country setting.

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“…Additionally, the two available trials involve highly selected patients, implying that AE rates observed in a patient population treated in a real-world practice setting are likely to be higher than those applied to this analysis. A recent study which adjusted for imbalances in ethnic origin and smoking status between the erlotinib pemetrexed treated populations as shown in Table 1 found that the two first-line maintenance regimens are similarly efficacious as concerns overall survival but differ in other parameters such as tolerability, drug administration (oral vs. intravenous) and patient convenience [14]. From these two studies it might be concluded that patients tolerated erlotinib maintenance therapy better and experienced less grade 3/4 AEs altogether (12%) than patients treated with a pemetrexed maintenance regimen (16%).…”

Section: Discussionmentioning

confidence: 99%

Comparison of treatment costs of grade 3/4 adverse events associated with erlotinib or pemetrexed maintenance therapy for patients with advanced non-small-cell lung cancer (NSCLC) in Germany, France, Italy, and Spain

Banz¹,

Bischoff²,

Brunner³

et al. 2011

Lung Cancer

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Pcn20 Maintenance Erlotinib Versus Pemetrexed for the Treatment of Non-Small Cell Lung Cancer: Indirect Comparison Applying Real-Life Outcomes

Cited by 4 publications

References 0 publications

Cross-market cost-effectiveness analysis of erlotinib as first-line maintenance treatment for patients with stable non-small cell lung cancer

Cross-market cost-effectiveness analysis of erlotinib as first-line maintenance treatment for patients with stable non-small cell lung cancer

Maintenance erlotinib in advanced nonsmall cell lung cancer: cost-effectiveness in EGFR wild-type across Europe

Comparison of treatment costs of grade 3/4 adverse events associated with erlotinib or pemetrexed maintenance therapy for patients with advanced non-small-cell lung cancer (NSCLC) in Germany, France, Italy, and Spain

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