Economic analysis of first-line treatment with erlotinib in an EGFR-mutated population with advanced NSCLC

Alain Vergnenegre, Bartomeu Massuti, Filippo De Marinis, Enric Carcereny, Enriqueta Felip, Pascal Do, Jose Miguel Sanchez, Luis Paz-Arez, Christos Chouaid, Rafael Rosell

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Introduction: The cost-effectiveness of first-line tyrosine kinase inhibitor therapy in epidermal growth factor receptor gene (EGFR)-mutated advanced-stage non-small cell lung cancer (NSCLC) is poorly documented. We therefore conducted a cost-effectiveness analysis of first-line treatment with erlotinib versus standard chemotherapy in European patients with advanced-stage EGFR-mutated NSCLC who were enrolled in the European Erlotinib versus Chemotherapy trial. Methods: The European Erlotinib versus Chemotherapy study was a multicenter, open-label, randomized phase III trial performed mainly in Spain, France, and Italy. We based our economic analysis on clinical data and data on resource consumption (drugs, drug administration, adverse events, and second-line treatments) collected during this trial. Utility values were derived from the literature. Incremental cost-effectiveness ratios were calculated for the first-line treatment phase and for the overall strategy from the perspective of the three participating countries. Sensitivity analyses were performed by selecting the main cost drivers. Results: Compared with standard first-line chemotherapy, the first-line treatment with erlotinib was cost saving (V7807, V17,311, and V19,364 for Spain, Italy and France, respectively) and yielded a gain of 0.117 quality-adjusted life-years. A probabilistic sensitivity analysis indicated that, given a willingness to pay at least V90,000 for 1 quality-adjusted life-year, the probability that a strategy of first-line erlotinib would be cost-effective was 100% in France, 100% in Italy, and 99.8% in Spain. Conclusion: This economic analysis shows that first-line treatment with erlotinib, versus standard chemotherapy, is a dominant strategy for EGFR-mutated advanced-stage NSCLC in three European countries.

Original languageEnglish
Pages (from-to)801-807
Number of pages7
JournalJournal of Thoracic Oncology
Volume11
Issue number6
DOIs
Publication statusPublished - 2016

Fingerprint

erbB-1 Genes
Non-Small Cell Lung Carcinoma
Economics
Drug Therapy
Spain
Italy
Population
France
Cost-Benefit Analysis
Quality-Adjusted Life Years
Costs and Cost Analysis
Therapeutics
Drug-Related Side Effects and Adverse Reactions
Protein-Tyrosine Kinases
Erlotinib Hydrochloride
Pharmaceutical Preparations

Keywords

  • Economical analysis
  • EGFR-mutated patients
  • Non-small cell lung cancer
  • Tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Economic analysis of first-line treatment with erlotinib in an EGFR-mutated population with advanced NSCLC. / Vergnenegre, Alain; Massuti, Bartomeu; De Marinis, Filippo; Carcereny, Enric; Felip, Enriqueta; Do, Pascal; Sanchez, Jose Miguel; Paz-Arez, Luis; Chouaid, Christos; Rosell, Rafael.

In: Journal of Thoracic Oncology, Vol. 11, No. 6, 2016, p. 801-807.

Research output: Contribution to journalArticle

Vergnenegre, A, Massuti, B, De Marinis, F, Carcereny, E, Felip, E, Do, P, Sanchez, JM, Paz-Arez, L, Chouaid, C & Rosell, R 2016, 'Economic analysis of first-line treatment with erlotinib in an EGFR-mutated population with advanced NSCLC', Journal of Thoracic Oncology, vol. 11, no. 6, pp. 801-807. https://doi.org/10.1016/j.jtho.2016.02.004
Vergnenegre, Alain ; Massuti, Bartomeu ; De Marinis, Filippo ; Carcereny, Enric ; Felip, Enriqueta ; Do, Pascal ; Sanchez, Jose Miguel ; Paz-Arez, Luis ; Chouaid, Christos ; Rosell, Rafael. / Economic analysis of first-line treatment with erlotinib in an EGFR-mutated population with advanced NSCLC. In: Journal of Thoracic Oncology. 2016 ; Vol. 11, No. 6. pp. 801-807.
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abstract = "Introduction: The cost-effectiveness of first-line tyrosine kinase inhibitor therapy in epidermal growth factor receptor gene (EGFR)-mutated advanced-stage non-small cell lung cancer (NSCLC) is poorly documented. We therefore conducted a cost-effectiveness analysis of first-line treatment with erlotinib versus standard chemotherapy in European patients with advanced-stage EGFR-mutated NSCLC who were enrolled in the European Erlotinib versus Chemotherapy trial. Methods: The European Erlotinib versus Chemotherapy study was a multicenter, open-label, randomized phase III trial performed mainly in Spain, France, and Italy. We based our economic analysis on clinical data and data on resource consumption (drugs, drug administration, adverse events, and second-line treatments) collected during this trial. Utility values were derived from the literature. Incremental cost-effectiveness ratios were calculated for the first-line treatment phase and for the overall strategy from the perspective of the three participating countries. Sensitivity analyses were performed by selecting the main cost drivers. Results: Compared with standard first-line chemotherapy, the first-line treatment with erlotinib was cost saving (V7807, V17,311, and V19,364 for Spain, Italy and France, respectively) and yielded a gain of 0.117 quality-adjusted life-years. A probabilistic sensitivity analysis indicated that, given a willingness to pay at least V90,000 for 1 quality-adjusted life-year, the probability that a strategy of first-line erlotinib would be cost-effective was 100{\%} in France, 100{\%} in Italy, and 99.8{\%} in Spain. Conclusion: This economic analysis shows that first-line treatment with erlotinib, versus standard chemotherapy, is a dominant strategy for EGFR-mutated advanced-stage NSCLC in three European countries.",
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AU - Vergnenegre, Alain

AU - Massuti, Bartomeu

AU - De Marinis, Filippo

AU - Carcereny, Enric

AU - Felip, Enriqueta

AU - Do, Pascal

AU - Sanchez, Jose Miguel

AU - Paz-Arez, Luis

AU - Chouaid, Christos

AU - Rosell, Rafael

PY - 2016

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N2 - Introduction: The cost-effectiveness of first-line tyrosine kinase inhibitor therapy in epidermal growth factor receptor gene (EGFR)-mutated advanced-stage non-small cell lung cancer (NSCLC) is poorly documented. We therefore conducted a cost-effectiveness analysis of first-line treatment with erlotinib versus standard chemotherapy in European patients with advanced-stage EGFR-mutated NSCLC who were enrolled in the European Erlotinib versus Chemotherapy trial. Methods: The European Erlotinib versus Chemotherapy study was a multicenter, open-label, randomized phase III trial performed mainly in Spain, France, and Italy. We based our economic analysis on clinical data and data on resource consumption (drugs, drug administration, adverse events, and second-line treatments) collected during this trial. Utility values were derived from the literature. Incremental cost-effectiveness ratios were calculated for the first-line treatment phase and for the overall strategy from the perspective of the three participating countries. Sensitivity analyses were performed by selecting the main cost drivers. Results: Compared with standard first-line chemotherapy, the first-line treatment with erlotinib was cost saving (V7807, V17,311, and V19,364 for Spain, Italy and France, respectively) and yielded a gain of 0.117 quality-adjusted life-years. A probabilistic sensitivity analysis indicated that, given a willingness to pay at least V90,000 for 1 quality-adjusted life-year, the probability that a strategy of first-line erlotinib would be cost-effective was 100% in France, 100% in Italy, and 99.8% in Spain. Conclusion: This economic analysis shows that first-line treatment with erlotinib, versus standard chemotherapy, is a dominant strategy for EGFR-mutated advanced-stage NSCLC in three European countries.

AB - Introduction: The cost-effectiveness of first-line tyrosine kinase inhibitor therapy in epidermal growth factor receptor gene (EGFR)-mutated advanced-stage non-small cell lung cancer (NSCLC) is poorly documented. We therefore conducted a cost-effectiveness analysis of first-line treatment with erlotinib versus standard chemotherapy in European patients with advanced-stage EGFR-mutated NSCLC who were enrolled in the European Erlotinib versus Chemotherapy trial. Methods: The European Erlotinib versus Chemotherapy study was a multicenter, open-label, randomized phase III trial performed mainly in Spain, France, and Italy. We based our economic analysis on clinical data and data on resource consumption (drugs, drug administration, adverse events, and second-line treatments) collected during this trial. Utility values were derived from the literature. Incremental cost-effectiveness ratios were calculated for the first-line treatment phase and for the overall strategy from the perspective of the three participating countries. Sensitivity analyses were performed by selecting the main cost drivers. Results: Compared with standard first-line chemotherapy, the first-line treatment with erlotinib was cost saving (V7807, V17,311, and V19,364 for Spain, Italy and France, respectively) and yielded a gain of 0.117 quality-adjusted life-years. A probabilistic sensitivity analysis indicated that, given a willingness to pay at least V90,000 for 1 quality-adjusted life-year, the probability that a strategy of first-line erlotinib would be cost-effective was 100% in France, 100% in Italy, and 99.8% in Spain. Conclusion: This economic analysis shows that first-line treatment with erlotinib, versus standard chemotherapy, is a dominant strategy for EGFR-mutated advanced-stage NSCLC in three European countries.

KW - Economical analysis

KW - EGFR-mutated patients

KW - Non-small cell lung cancer

KW - Tyrosine kinase inhibitors

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