Prevalence Utilization Patterns and Economic Impact of eGFR and ALK-Targeted Therapies in Non-Small Cell Lung Cancer: A Nationwide Real-World Analysis From Greece
Author(s)
George Gourzoulidis, PhD1, Catherine Kastanioti, PhD1, George Mavridoglou, PhD2, Thodoris Kotsilieris, PhD1, Anastasios Tsolakidis, PhD3, Kostas Mathioudakis, PhD3, Dikaios Voudigaris, MSc4, Charalampos Tzanetakos, MSc5.
1Department of Business and Organizations Administration, University of the Peloponnese, Kalamata, Greece, 2Department of Accounting and Finance, University of the Peloponnese, Kalamata, Greece, 3IDIKA SA - e-Government Center for Social Security Services, Athens, Greece, 4Health Through Evidence, Athens, Greece, 5Health Through Evidece, Athens, Greece.
1Department of Business and Organizations Administration, University of the Peloponnese, Kalamata, Greece, 2Department of Accounting and Finance, University of the Peloponnese, Kalamata, Greece, 3IDIKA SA - e-Government Center for Social Security Services, Athens, Greece, 4Health Through Evidence, Athens, Greece, 5Health Through Evidece, Athens, Greece.
OBJECTIVES: To determine the prescribing prevalence of epidermal growth factor receptor(EGFR) and anaplastic lymphoma kinase(ALK)-positive non-small cell lung cancer(NSCLC) patients in Greece and examine patterns of first-line tyrosine kinase inhibitor(TKI) utilization and associated treatment costs using nationwide real-world-data.
METHODS: A retrospective analysis of the national e-prescription database was performed, identifying patients initiating first-line treatment(FLT) for EGFR or ALK-positive NSCLC between January 1, 2020, and December 31, 2022. Demographic characteristics, prevalence data, drug utilization patterns, total annual drug expenditures, and per patient treatment costs were assessed. All statistical analyses were performed using the statistical software SPSS-v.29.
RESULTS: Overall, 1,188 EGFR -positive(mean age of 70.9. ±11.6) and 246(mean age of 64.2 ±12.6) ALK-positive NSCLC patients-initiated FLT during the three-year study period. EGFR mutations predominated slightly among females (53%) and peaked in the 70-79 age group(35%). ALK mutations were also more common among females(52%), particularly within the 60-79 age group. In EGFR -positive patients, osimertinib usage markedly increased from 42% in 2020 to 63% in 2022, primarily displacing afatinib(from 32% to 22%) and erlotinib(from 24% to 14%), with gefitinib prescriptions falling below 2%. Among ALK-positive patients, crizotinib utilization declined significantly from 60% to 16%, whereas alectinib increased to 71% by 2022. Annual EGFR -related total drug expenditures remained stable (€11.5 million in 2020 vs. €11.8 million in 2022), driven primarily by increasing osimertinib usage. Similarly, ALK-related annual drug expenditures showed stability, with costs predominantly attributed to rising alectinib utilization.
CONCLUSIONS: This nationwide analysis highlights the rapid uptake of third and second-generation TKIs for EGFR- and ALK-positive NSCLC in Greece, reflecting evolving clinical practice patterns. Although the target patient populations are relatively small, the associated economic burden is considerable. To ensure long-term sustainability of the Greek healthcare system, policymakers should critically assess the cost-effectiveness of these innovative therapies and align resource allocation with value-based care principles
METHODS: A retrospective analysis of the national e-prescription database was performed, identifying patients initiating first-line treatment(FLT) for EGFR or ALK-positive NSCLC between January 1, 2020, and December 31, 2022. Demographic characteristics, prevalence data, drug utilization patterns, total annual drug expenditures, and per patient treatment costs were assessed. All statistical analyses were performed using the statistical software SPSS-v.29.
RESULTS: Overall, 1,188 EGFR -positive(mean age of 70.9. ±11.6) and 246(mean age of 64.2 ±12.6) ALK-positive NSCLC patients-initiated FLT during the three-year study period. EGFR mutations predominated slightly among females (53%) and peaked in the 70-79 age group(35%). ALK mutations were also more common among females(52%), particularly within the 60-79 age group. In EGFR -positive patients, osimertinib usage markedly increased from 42% in 2020 to 63% in 2022, primarily displacing afatinib(from 32% to 22%) and erlotinib(from 24% to 14%), with gefitinib prescriptions falling below 2%. Among ALK-positive patients, crizotinib utilization declined significantly from 60% to 16%, whereas alectinib increased to 71% by 2022. Annual EGFR -related total drug expenditures remained stable (€11.5 million in 2020 vs. €11.8 million in 2022), driven primarily by increasing osimertinib usage. Similarly, ALK-related annual drug expenditures showed stability, with costs predominantly attributed to rising alectinib utilization.
CONCLUSIONS: This nationwide analysis highlights the rapid uptake of third and second-generation TKIs for EGFR- and ALK-positive NSCLC in Greece, reflecting evolving clinical practice patterns. Although the target patient populations are relatively small, the associated economic burden is considerable. To ensure long-term sustainability of the Greek healthcare system, policymakers should critically assess the cost-effectiveness of these innovative therapies and align resource allocation with value-based care principles
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD137
Topic
Health Policy & Regulatory, Health Technology Assessment, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Oncology