Cancer Management and Research (May 2021)

Cost-Effectiveness Analysis of Dacomitinib versus Gefitinib in the First-Line Treatment of EGFR-Positive Advanced or Metastatic Non-Small Cell Lung Cancer

  • Zhang L,
  • Li N,
  • Liu M,
  • Zheng B,
  • Wu Z,
  • Cai H

Journal volume & issue
Vol. Volume 13
pp. 4263 – 4270

Abstract

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Longfeng Zhang,1 Na Li,2 Maobai Liu,2 Bin Zheng,2 Zhijuan Wu,3 Hongfu Cai2 1Department of Thoracic Oncology, Fujian Provincial Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian Province, People’s Republic of China; 2Department of Pharmacy, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China; 3Department of Physiology and Pathophysiology, The School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of ChinaCorrespondence: Hongfu Cai; Maobai LiuDepartment of Pharmacy, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, People’s Republic of ChinaEmail [email protected]; [email protected]: The objective of the study was to evaluate the economics of dacomitinib and gefitinib in the first-line treatments for EGFR-positive advanced or metastatic non-small cell lung cancer (NSCLC) from a US payer perspective.Methods: We developed the partition survival model to compare the lifetime cost and health outcomes of dacomitinib versus gefitinib. Transition probabilities were collected from the ARCHER 1050 trial. The model only considered the direct medical costs. Utility values were taken from published research.Results: Compared to gefitinib, dacomitinib increased 0.706 QALY and the cost increased $232,359.32. The incremental cost-effectiveness ratio (ICER) was $329,120.85 per QALY in the base case. One-way sensitivity analysis showed that the cost of drugs and the utility had more influence on the results than other parameters. Probability sensitivity analysis reflected that the parameters had little effect on the results.Conclusion: Dacomitinib could improve the health benefits and increase the overall costs. In this simulation, dacomitinib is not likely to be economical for first-line therapy of EGFR-mutated NSCLC.Keywords: dacomitinib, gefitinib, cost-effectiveness, non-small cell lung cancer

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