Yamin Shu1,2,3,4, Qilin Zhang5, Xucheng He6, Li Chen1,2,3. 1. Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China. 2. Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China. 3. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, People's Republic of China. 4. Department of Pharmacy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People's Republic of China. 5. Department of Pharmacy, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People's Republic of China. 6. Pengzhou Second People's Hospital, Pengzhou, People's Republic of China.
Abstract
OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of gefitinib plus chemotherapy (GCP) versus gefitinib alone for advanced non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations in China. METHODS: A decision-analytic Markov model was conducted to simulate the disease process of advanced NSCLC patients with EGFR mutations. Three distinct health states: progression-free survival (PFS), progressive disease (PD) and death were included. Clinical data were derived from the NEJ009 study. The cost was evaluated from the perspective of the Chinese society. Quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICER) were calculated over a 10-year lifetime horizon. One-way sensitivity analysis and probabilistic sensitivity analysis were also performed to explore the uncertainty of parameters in the study. RESULTS: The base case analysis demonstrated that gefitinib plus chemotherapy gained 2.44 QALYs at an average cost of $59,571.34, while the effectiveness and cost of gefitinib group were 1.82 QALYs and $52,492.75, respectively. The ICER for gefitinib plus chemotherapy was $11,499.98 per QALY gained. The ICER was lower than the accepted willingness-to-pay (WTP) threshold, which was three times gross domestic product (GDP) per capita of China ($31,498.70 per QALY). Variation of parameters did not reverse the cost-effectiveness of gefitinib plus chemotherapy through univariable and probabilistic sensitivity analyses. CONCLUSION: Our results showed that gefitinib plus chemotherapy is a cost-effective treatment option compared with gefitinib for advanced NSCLC patients with EGFR mutations in China.
OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of gefitinib plus chemotherapy (GCP) versus gefitinib alone for advanced non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations in China. METHODS: A decision-analytic Markov model was conducted to simulate the disease process of advanced NSCLC patients with EGFR mutations. Three distinct health states: progression-free survival (PFS), progressive disease (PD) and death were included. Clinical data were derived from the NEJ009 study. The cost was evaluated from the perspective of the Chinese society. Quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICER) were calculated over a 10-year lifetime horizon. One-way sensitivity analysis and probabilistic sensitivity analysis were also performed to explore the uncertainty of parameters in the study. RESULTS: The base case analysis demonstrated that gefitinib plus chemotherapy gained 2.44 QALYs at an average cost of $59,571.34, while the effectiveness and cost of gefitinib group were 1.82 QALYs and $52,492.75, respectively. The ICER for gefitinib plus chemotherapy was $11,499.98 per QALY gained. The ICER was lower than the accepted willingness-to-pay (WTP) threshold, which was three times gross domestic product (GDP) per capita of China ($31,498.70 per QALY). Variation of parameters did not reverse the cost-effectiveness of gefitinib plus chemotherapy through univariable and probabilistic sensitivity analyses. CONCLUSION: Our results showed that gefitinib plus chemotherapy is a cost-effective treatment option compared with gefitinib for advanced NSCLC patients with EGFR mutations in China.
Authors: J J Yang; Q Zhou; H H Yan; X C Zhang; H J Chen; H Y Tu; Z Wang; C R Xu; J Su; B C Wang; B Y Jiang; X Y Bai; W Z Zhong; X N Yang; Y L Wu Journal: Br J Cancer Date: 2017-01-19 Impact factor: 7.640