Cargando…
A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer
INTRODUCTION: Lung cancer, the most prevalent malignant cancer in the world, remains a serious threat to public health. Recently, a large number of studies have shown that an epidermoid growth factor receptor-tyrosine kinase inhibitor (EGFR TKI), Erlotinib, has significantly better efficacy and is b...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592875/ https://www.ncbi.nlm.nih.gov/pubmed/23520448 http://dx.doi.org/10.1371/journal.pone.0055917 |
_version_ | 1782262201760874496 |
---|---|
author | Wang, Siying Peng, Liubao Li, Jianhe Zeng, Xiaohui Ouyang, Lihui Tan, Chongqing Lu, Qiong |
author_facet | Wang, Siying Peng, Liubao Li, Jianhe Zeng, Xiaohui Ouyang, Lihui Tan, Chongqing Lu, Qiong |
author_sort | Wang, Siying |
collection | PubMed |
description | INTRODUCTION: Lung cancer, the most prevalent malignant cancer in the world, remains a serious threat to public health. Recently, a large number of studies have shown that an epidermoid growth factor receptor-tyrosine kinase inhibitor (EGFR TKI), Erlotinib, has significantly better efficacy and is better tolerated in advanced non-small cell lung cancer (NSCLC) patients with a positive EGFR gene mutation. However, access to this drug is severely limited in China due to its high acquisition cost. Therefore, we decided to conduct a study to compare cost-effectiveness between erlotinib monotherapy and carboplatin-gemcitabine (CG) combination therapy in patients with advanced EGFR mutation-positive NSCLC. METHODS: A Markov model was developed from the perspective of the Chinese health care system to evaluate the cost-effectiveness of the two treatment strategies; this model was based on data from the OPTIMAL trial, which was undertaken at 22 centres in China. The 10-year quality-adjusted life years (QALYs), direct costs, and incremental cost-effectiveness ratio (ICER) were estimated. To allow for uncertainties within the parameters and to estimate the model robustness, one-way sensitivity analysis and probabilistic sensitivity analysis were performed. RESULTS: The median progression-free survival (PFS) obtained from Markov model was 13.2 months (13.1 months was reported in the trial) in the erlotinib group while and 4.64 months (4.6 months was reported in the trial) in the CG group. The QALYs were 1.4 years in the erlotinib group and 1.96 years in the CG group, indicating difference of 0.56 years. The ICER was most sensitive to the health utility of DP ranged from $58,584.57 to $336,404.2. At a threshold of $96,884, erlotinib had a 50%probability of being cost-effective. CONCLUSIONS: Erlotinib monotherapy is more cost-effective compared with platinum-based doublets chemotherapy as a first-line therapy for advanced EGFR mutation- positive NSCLC patients from within the Chinese health care system. |
format | Online Article Text |
id | pubmed-3592875 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-35928752013-03-21 A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer Wang, Siying Peng, Liubao Li, Jianhe Zeng, Xiaohui Ouyang, Lihui Tan, Chongqing Lu, Qiong PLoS One Research Article INTRODUCTION: Lung cancer, the most prevalent malignant cancer in the world, remains a serious threat to public health. Recently, a large number of studies have shown that an epidermoid growth factor receptor-tyrosine kinase inhibitor (EGFR TKI), Erlotinib, has significantly better efficacy and is better tolerated in advanced non-small cell lung cancer (NSCLC) patients with a positive EGFR gene mutation. However, access to this drug is severely limited in China due to its high acquisition cost. Therefore, we decided to conduct a study to compare cost-effectiveness between erlotinib monotherapy and carboplatin-gemcitabine (CG) combination therapy in patients with advanced EGFR mutation-positive NSCLC. METHODS: A Markov model was developed from the perspective of the Chinese health care system to evaluate the cost-effectiveness of the two treatment strategies; this model was based on data from the OPTIMAL trial, which was undertaken at 22 centres in China. The 10-year quality-adjusted life years (QALYs), direct costs, and incremental cost-effectiveness ratio (ICER) were estimated. To allow for uncertainties within the parameters and to estimate the model robustness, one-way sensitivity analysis and probabilistic sensitivity analysis were performed. RESULTS: The median progression-free survival (PFS) obtained from Markov model was 13.2 months (13.1 months was reported in the trial) in the erlotinib group while and 4.64 months (4.6 months was reported in the trial) in the CG group. The QALYs were 1.4 years in the erlotinib group and 1.96 years in the CG group, indicating difference of 0.56 years. The ICER was most sensitive to the health utility of DP ranged from $58,584.57 to $336,404.2. At a threshold of $96,884, erlotinib had a 50%probability of being cost-effective. CONCLUSIONS: Erlotinib monotherapy is more cost-effective compared with platinum-based doublets chemotherapy as a first-line therapy for advanced EGFR mutation- positive NSCLC patients from within the Chinese health care system. Public Library of Science 2013-03-08 /pmc/articles/PMC3592875/ /pubmed/23520448 http://dx.doi.org/10.1371/journal.pone.0055917 Text en © 2013 Wang et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Wang, Siying Peng, Liubao Li, Jianhe Zeng, Xiaohui Ouyang, Lihui Tan, Chongqing Lu, Qiong A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer |
title | A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer |
title_full | A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer |
title_fullStr | A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer |
title_full_unstemmed | A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer |
title_short | A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer |
title_sort | trial-based cost-effectiveness analysis of erlotinib alone versus platinum-based doublet chemotherapy as first-line therapy for eastern asian nonsquamous non–small-cell lung cancer |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592875/ https://www.ncbi.nlm.nih.gov/pubmed/23520448 http://dx.doi.org/10.1371/journal.pone.0055917 |
work_keys_str_mv | AT wangsiying atrialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT pengliubao atrialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT lijianhe atrialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT zengxiaohui atrialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT ouyanglihui atrialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT tanchongqing atrialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT luqiong atrialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT wangsiying trialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT pengliubao trialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT lijianhe trialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT zengxiaohui trialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT ouyanglihui trialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT tanchongqing trialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer AT luqiong trialbasedcosteffectivenessanalysisoferlotinibaloneversusplatinumbaseddoubletchemotherapyasfirstlinetherapyforeasternasiannonsquamousnonsmallcelllungcancer |