COST-EFFECTIVENESS OF DACOMITINIB VS. GEFITINIB AS FIRST-LINE TREATMENT FOR EGFR MUTATION POSITIVE ADVANCED NON-SMALL-CELL LUNG CANCER IN CHINA
Author(s)
Yu Y1, Luan L2, Zhu F3, Dong P4, Li L5, Lin Y6, Lu S1
1Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China, 2Pfizer Investment Co., Ltd., Beijing, 11, China, 3Pfizer Investment Co., Ltd., Shanghai, China, 4Pfizer Investment Co., Ltd., Beijing, China, 5Pfizer Investment Co., Ltd., Beijing, 31, China, 6Shanghai Palan DataRx Co., Ltd., Shanghai, China
Presentation Documents
OBJECTIVES Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors have been the standard treatment options for EGFR mutation positive advanced non-small cell lung cancer (NSCLC). In an international, phase III, randomised study（ARCHER1050）, dacomitinib showed significant efficacy improvements over gefitinib for the first-line treatment of locally advanced or metastatic NSCLC with EGFR activating mutations. However, the economic impact of dacomitinib was unknown. Therefore, this study aimed to compare the cost-effectiveness of dacomitinib versus gefitinib for the first-line treatment of patients with EGFR mutation positive advanced NSCLC in China from healthcare systems perspective. METHODS We developed a partitioned survival model to reflect the disease progression and treatment pattern of NSCLC with three health states, referring to progression-free survival, post-progression survival, and death. The proportion of patients in each state was estimated based upon parametric survival equations. Clinical efficacy data was extracted from trial ARCHER1050. Costs and utilities for each line of treatments were generated from publications. A discount of 3% per year was applied. Quality-adjusted life-years (QALYs) were used as the primary health outcome. The health outcome of QALY and the incremental cost effectiveness ratio (ICER) were calculated. One-way sensitivity and probabilistic sensitivity analyses were conducted to test the uncertainty of the model. RESULTS In the base-case scenario, dacomitinib resulted in a gain of 0.3377 QALYs and an incremental cost of US$6,665 compared with gefitinib. The incremental cost per QALY gain was US$19,737/QALY. The sensitivity analysis suggested that at the willingness-to-pay threshold of US$ 28,872, dacomitinib has 81% probability to be a cost-effective treatment option compared with gefitinib. CONCLUSIONS Dacomitinib is projected to be a cost-effective option compared to gefitinib as first-line treatment for patients with EGFR mutation positive advanced NSCLC in China.
Conference/Value in Health Info
2019-11, ISPOR Europe 2019, Copenhagen, Denmark
Code
PCN164
Topic
Clinical Outcomes, Economic Evaluation, Methodological & Statistical Research
Topic Subcategory
Comparative Effectiveness or Efficacy, Modeling and simulation, Novel & Social Elements of Value
Disease
Oncology