Presentation (CTI)

OBJECTIVES: Zorifertinib, a China-developed novel epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), specifically for EGFR-mutant (EGFRm+) non-small cell lung cancer (NSCLC) with central nervous system (CNS) metastases, addresses the unmet need in this poor-prognosis population. This study aimed to evaluate the cost-effectiveness of zorifertinib versus osimertinib in newly diagnosed EGFRm+ NSCLC patients with CNS metastases from the Chinese healthcare perspective.
METHODS: A lifetime partitioned survival model with four states (progression-free survival, non-CNS progression, CNS progression, and death) and a 30-day cycle was developed. An anchored matching-adjusted indirect comparison (MAIC) was used for survival analyses, based on individual patient data from the EVEREST trial (NCT03653546) and published aggregate data from the FLAURA trial (NCT02296125) and a retrospective study of osimertinib. Zorifertinib survival was modeled via hazard ratios (HRs) applied to osimertinib survival curves. Utility values and direct medical costs were obtained from published literature and clinical expert consultations. A discount rate of 4.5% was applied. Robustness was verified via one-way and probabilistic sensitivity analyses. In one scenario, the HRs were applied to extrapolated survival curves of zorifertinib to obtain osimertinib survival. Considering real-world clinical settings, another scenario analysis was performed to explore the economic impact of sequential use of third-generation EGFR-TKIs therapy following initial zorifertinib versus osimertinib treatment.
RESULTS: In the base case analysis, compared with osimertinib, zorifertinib saved CNY 80,071 (CNY 312,879 vs. CNY 392,950) and gained an additional 0.34 (2.83 vs. 2.49) quality-adjusted life years (QALYs), making it a dominant treatment option. Comprehensive sensitivity analyses and scenario analyses further confirmed the robustness of the results, with zorifertinib remaining cost-effective across most sensitivity scenarios.
CONCLUSIONS: From the perspective of the Chinese healthcare system, zorifertinib is a cost-effective treatment for newly diagnosed EGFRm+ NSCLC patients with CNS metastases compared with osimertinib, which provided patients with an effective and cost-saving treatment option.