Gene-guided Gefitinib Switch Maintenance Therapy for Patients with Advanced EGFR Mutation-positive Non-small Cell Lung Cancer: an Economic Analysis

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2013 Jan 31

PMID 23360224

Citations 18

Authors

Jun Zhu

Te Li

Xiaohui Wang

Ming Ye

Jian Cai

Yuejuan Xu

Bin Wu

Affiliations

Soon will be listed here.

Abstract

Background: Maintenance therapy with gefitinib notably improves survival in patients with advanced non-small cell lung cancer (NSCLC) and EGFR mutation-positive tumors, but the economic impact of this practice is unclear.

Methods: A decision-analytic model was developed to simulate 21-day patient transitions in a 10-year time horizon. The clinical data were primarily obtained from the results of a pivotal phase III trial that assessed gefitinib maintenance treatment in patients with advanced NSCLC. The cost data were derived from the perspective of the Chinese health care system. The primary outcome was the incremental cost-effectiveness ratio (ICER) at a willingness-to-pay (WTP) threshold of 3 times the per capita GDP of China. Sensitivity analyses were used to explore the impact of uncertainty regarding the results. The impact of the gefitinib patient assistance program (GPAP) was evaluated.

Results: After EGFR genotyping, gefitinib maintenance treatment for advanced NSCLC with EGFR mutations increased the life expectancy by 0.74 years and 0.46 QALYs compared with routine follow-up at an additional cost of $26,149.90 USD ($7,178.20 with the GPAP). The ICER for gefitinib maintenance was $57,066.40 and $15,664.80 per QALY gained (at a 3% discount rate) without and with the GPAP, respectively. The utility of progression free survival, the hazard ratio of progression-free survival for gefitinib treatment and the cost of gefitinib per dose were the three factors that had the greatest influence on the results.

Conclusions: These results indicate that gene-guided maintenance therapy with gefitinib with the GPAP might be a cost-effective treatment option.

Citing Articles

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Cost-Effectiveness Analysis Of EGFR Mutation Testing And Afatinib Versus Gemcitabine-Cisplatin As First-Line Therapy For Advanced Non-Small-Cell Lung Cancer In China.

You R, Liu J, Wu D, Qian X, Lyu B, Zhang Y Cancer Manag Res. 2019; 11:10239-10248.

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