Distinct Models to Assess the Cost-effectiveness of EGFR-tyrosine Kinase Inhibitors for the Treatment of Metastatic Non-small Cell Lung Cancer in the Context of the Brazilian Unified Health Care System

Overview

Journal J Bras Pneumol

Specialty Pulmonary Medicine

Date 2020 Jun 4

PMID 32490907

Citations 1

Authors

Pedro Aguiar Jr

Felipe Roitberg

Gilberto Lopes Jr

Auro Del Giglio

Affiliations

Soon will be listed here.

Abstract

Objective: Lung cancer is an important health problem due to its high incidence and mortality. The treatment of metastatic disease improved after the molecular pathways of cancer came to be known. However, targeted therapy is unavailable to many patients treated within the Brazilian Sistema Único de Saúde (SUS, Unified Health Care System). Our objective was to assess the cost-effectiveness of erlotinib, gefitinib, and afatinib versus that of chemotherapy for the treatment of non-small cell lung cancer in the context of the SUS.

Methods: Different analytical models were developed based on data in the literature. The outcomes were presented in quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) per QALY gained. All costs related to treatment and supportive therapies were included in the models.

Results: In one model, data from retrospective studies showed 2.01 life-years saved and a mean QALY gain of 1.169. The ICER per QALY gained ranged from R$48,451.29 (for gefitinib) to R$85,559.22 (for erlotinib). In another model, data from a meta-analysis showed -0.01 life-years saved and a mean QALY gain of 0.178. The ICER per QALY gained ranged from R$27,028.30 (for gefitinib) to R$75,203.26 (for erlotinib).

Conclusions: There is no ideal analytical model for the SUS. However, targeted therapy with EGFR-tyrosine kinase inhibitors has been shown to be cost-effective in various scenarios. The adoption of drug price discounts will improve the cost-effectiveness of treatment.

Citing Articles

Challenging scenarios in the treatment of lung cancer.

Gelatti A, Lorandi V J Bras Pneumol. 2020; 46(4):e20200388.

PMID: 32901690 PMC: 7567615. DOI: 10.36416/1806-3756/e20200388.

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