DEVELOPMENT AND VALIDATION OF A DISEASE MODEL FOR NON-SMALL CELL LUNG CANCER
Author(s)
David C. Griffin, MDSA1, Syed Irteza Abbas Shamsi, BSc2, Amanda AW Gibson, BSc3, Michelle L. Dean, BSc3, Vishal Navani, MA (Oxon), MBBS, MRCP, FRACP3, Winson Cheung, MD, MPH, FRCPC2, Alain Tremblay, MDCM, FRCPC, FCCP4, Eldon Spackman, PhD5.
1Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, 2Oncology Outcomes Initiative, University of Calgary, Calgary, AB, Canada, 3Glans-Look Lung Cancer Research (GLR) Program, Department of Oncology, Cumming School of Medicine,, University of Calgary, Calgary, AB, Canada, 4Department of Medicine, Cumming School of Medicine,, University of Calgary, Calgary, AB, Canada, 5O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
1Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, 2Oncology Outcomes Initiative, University of Calgary, Calgary, AB, Canada, 3Glans-Look Lung Cancer Research (GLR) Program, Department of Oncology, Cumming School of Medicine,, University of Calgary, Calgary, AB, Canada, 4Department of Medicine, Cumming School of Medicine,, University of Calgary, Calgary, AB, Canada, 5O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
OBJECTIVES: Lung Cancer is the leading cause of cancer-related death in Canada, with Non-Small Cell Lung Cancer (NSCLC) representing 88% of diagnoses. Recent advances in treatment have increased both survival and costs. Most existing NSCLC economic evaluations utilize simple piecewise models not intended for reuse, with few reporting model validation. To address this, we developed and validated a microsimulation model for NSCLC and performed a case study assessing the cost-effectiveness of the FLAURA2 and MARIPOSA trials against Osimertinib monotherapy.
METHODS: Utilizing survival data from the Glans-Look database, list prices, and relevant literature, a discrete-time microsimulation with a 25-year time horizon was developed that estimates average costs and quality-adjusted life years (QALYs) for NSCLC. Predicted survival was validated internally against the Glans-Look sample and externally against reported survival in observational studies and population-level outcomes, with mean absolute percent error (MAPE) and R2 coefficients calculated for each. Results of the case study were compared to Canada’s Drug Agency (CDA) analyses.
RESULTS: NSCLC was estimated to cost $209,035 (95% CI: 213,522, 204,549) with average QALYs per case of 3.47 (95%-CI: 3.55, 3.4). Predicted survival had an internal MAPE of 8.8% and R2 of 0.9705 against the Glans-Look sample and a MAPE of 15.2% and R2 of 0.8771 externally. Estimated incremental costs for Osimertinib plus platinum pemetrexed and Amivantamab plus Lazertinib against Osimertinib were $107,841 (95%-CI: 110,219, 105,464) and $180,130 (95%-CI: 184,158, 176,102), slightly lower than the CDA reanalysis ($123,145 and 203,322), and incremental QALYs were 0.386 (95%-CI: 0.402, 0.371) and 0.448 (95%-CI: 0.462, 0.434), similar to the CDAs deterministic/probabilistic findings of 0.49 and 0.66 QALYs gained. Incremental cost-effectiveness ratios were $279,130 and $402,423 per QALY.
CONCLUSIONS: The NSCLC model represents an internally and externally valid foundation for the assessment of new preventative and oncology health technology interventions in lung cancer in Canada.
METHODS: Utilizing survival data from the Glans-Look database, list prices, and relevant literature, a discrete-time microsimulation with a 25-year time horizon was developed that estimates average costs and quality-adjusted life years (QALYs) for NSCLC. Predicted survival was validated internally against the Glans-Look sample and externally against reported survival in observational studies and population-level outcomes, with mean absolute percent error (MAPE) and R2 coefficients calculated for each. Results of the case study were compared to Canada’s Drug Agency (CDA) analyses.
RESULTS: NSCLC was estimated to cost $209,035 (95% CI: 213,522, 204,549) with average QALYs per case of 3.47 (95%-CI: 3.55, 3.4). Predicted survival had an internal MAPE of 8.8% and R2 of 0.9705 against the Glans-Look sample and a MAPE of 15.2% and R2 of 0.8771 externally. Estimated incremental costs for Osimertinib plus platinum pemetrexed and Amivantamab plus Lazertinib against Osimertinib were $107,841 (95%-CI: 110,219, 105,464) and $180,130 (95%-CI: 184,158, 176,102), slightly lower than the CDA reanalysis ($123,145 and 203,322), and incremental QALYs were 0.386 (95%-CI: 0.402, 0.371) and 0.448 (95%-CI: 0.462, 0.434), similar to the CDAs deterministic/probabilistic findings of 0.49 and 0.66 QALYs gained. Incremental cost-effectiveness ratios were $279,130 and $402,423 per QALY.
CONCLUSIONS: The NSCLC model represents an internally and externally valid foundation for the assessment of new preventative and oncology health technology interventions in lung cancer in Canada.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MSR84
Topic
Economic Evaluation, Methodological & Statistical Research
Disease
Oncology