IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0055917.html
   My bibliography  Save this article

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

Author

Listed:
  • Siying Wang
  • Liubao Peng
  • Jianhe Li
  • Xiaohui Zeng
  • Lihui Ouyang
  • Chongqing Tan
  • Qiong Lu

Abstract

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.

Suggested Citation

  • Siying Wang & Liubao Peng & Jianhe Li & Xiaohui Zeng & Lihui Ouyang & Chongqing Tan & Qiong Lu, 2013. "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," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-9, March.
    • Handle: RePEc:plo:pone00:0055917
    DOI: 10.1371/journal.pone.0055917
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055917
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0055917&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0055917?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Xiaohui Zeng & Jonathan Karnon & Siying Wang & Bin Wu & Xiaomin Wan & Liubao Peng, 2012. "The Cost of Treating Advanced Non-Small Cell Lung Cancer: Estimates from the Chinese Experience," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-7, October.
    2. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
    3. Mathilda Bongers & Veerle Coupé & Elise Jansma & Egbert Smit & Carin Groot, 2012. "Cost Effectiveness of Treatment with New Agents in Advanced Non-Small-Cell Lung Cancer," PharmacoEconomics, Springer, vol. 30(1), pages 17-34, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Eun-A Lim & Haeyoung Lee & Eunmi Bae & Jaeok Lim & Young Kee Shin & Sang-Eun Choi, 2016. "Economic Evaluation of Companion Diagnostic Testing for EGFR Mutations and First-Line Targeted Therapy in Advanced Non-Small Cell Lung Cancer Patients in South Korea," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-14, August.
    2. Cuc Thi Thu Nguyen & Fabio Petrelli & Stefania Scuri & Binh Thanh Nguyen & Iolanda Grappasonni, 2019. "A systematic review of pharmacoeconomic evaluations of erlotinib in the first-line treatment of advanced non-small cell lung cancer," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 763-777, July.
    3. Chunxiang Zhang & Hongmei Zhang & Jinning Shi & Dong Wang & Xiuwei Zhang & Jian Yang & Qizhi Zhai & Aixia Ma, 2016. "Trial-Based Cost-Utility Analysis of Icotinib versus Gefitinib as Second-Line Therapy for Advanced Non-Small Cell Lung Cancer in China," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-10, March.
    4. Oscar Arrieta & Pablo Anaya & Vicente Morales-Oyarvide & Laura Alejandra Ramírez-Tirado & Ana C. Polanco, 2016. "Cost-effectiveness analysis of EGFR mutation testing in patients with non-small cell lung cancer (NSCLC) with gefitinib or carboplatin–paclitaxel," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(7), pages 855-863, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Michaël Schwarzinger & Jean‐Louis Lanoë & Erik Nord & Isabelle Durand‐Zaleski, 2004. "Lack of multiplicative transitivity in person trade‐off responses," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 171-181, February.
    2. Quartey, Jonathan D. & Nyarko, Lydia Gyamea, 2022. "Economic Sustainability of Mobile Money Payments in Ghana: Does a Tax on Transactions Matter?," African Journal of Economic Review, African Journal of Economic Review, vol. 10(5), December.
    3. Lai, Taavi & Habicht, Jarno & Reinap, Marge & Chisholm, Dan & Baltussen, Rob, 2007. "Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia," Health Policy, Elsevier, vol. 84(1), pages 75-88, November.
    4. Baltussen, Rob, 2006. "Priority setting of public spending in developing countries: Do not try to do everything for everybody," Health Policy, Elsevier, vol. 78(2-3), pages 149-156, October.
    5. Rutten, Frans & Bleichrodt, Han & Brouwer, Werner & Koopmanschap, Marc & Schut, Erik, 2001. "Handbook of Health Economics," Journal of Health Economics, Elsevier, vol. 20(5), pages 855-879, September.
    6. Cuc Thi Thu Nguyen & Fabio Petrelli & Stefania Scuri & Binh Thanh Nguyen & Iolanda Grappasonni, 2019. "A systematic review of pharmacoeconomic evaluations of erlotinib in the first-line treatment of advanced non-small cell lung cancer," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 763-777, July.
    7. Kapiriri, Lydia & Razavi, Donya, 2017. "How have systematic priority setting approaches influenced policy making? A synthesis of the current literature," Health Policy, Elsevier, vol. 121(9), pages 937-946.
    8. Mei-Chuan Hung & Hsin-Ming Lu & Likwang Chen & Ming-Shian Lin & Cheng-Ren Chen & Chong-Jen Yu & Jung-Der Wang, 2012. "Cost per QALY (Quality-Adjusted Life Year) and Lifetime Cost of Prolonged Mechanical Ventilation in Taiwan," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-10, September.
    9. Shepherd, Keith D. & Shepherd, Gemma & Walsh, Markus G., 2015. "Land health surveillance and response: A framework for evidence-informed land management," Agricultural Systems, Elsevier, vol. 132(C), pages 93-106.
    10. Graham Scotland & Stirling Bryan, 2017. "Why Do Health Economists Promote Technology Adoption Rather Than the Search for Efficiency? A Proposal for a Change in Our Approach to Economic Evaluation in Health Care," Medical Decision Making, , vol. 37(2), pages 139-147, February.
    11. Llanos, Adolfo & Hertrampf, Eva & Cortes, Fanny & Pardo, Andrea & Grosse, Scott D. & Uauy, Ricardo, 2007. "Cost-effectiveness of a folic acid fortification program in Chile," Health Policy, Elsevier, vol. 83(2-3), pages 295-303, October.
    12. Raymond C.W. Hutubessy & Rob M.P.M. Baltussen & David B. Evans & Jan J. Barendregt & Christopher J.L. Murray, 2001. "Stochastic league tables: communicating cost‐effectiveness results to decision‐makers," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 473-477, July.
    13. Milton C. Weinstein, 2012. "Decision Rules for Incremental Cost-effectiveness Analysis," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 47, Edward Elgar Publishing.
    14. Elahe Khorasani & Majid Davari & Abbas Kebriaeezadeh & Farshad Fatemi & Ali Akbari Sari & Vida Varahrami, 2022. "A comprehensive review of official discount rates in guidelines of health economic evaluations over time: the trends and roots," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1577-1590, December.
    15. Samia Laokri & Maxime Koiné Drabo & Olivier Weil & Benoît Kafando & Sary Mathurin Dembélé & Bruno Dujardin, 2013. "Patients Are Paying Too Much for Tuberculosis: A Direct Cost-Burden Evaluation in Burkina Faso," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-6, February.
    16. Ezzati, Majid & Kammen, Daniel M., 2002. "Evaluating the health benefits of transitions in household energy technologies in Kenya," Energy Policy, Elsevier, vol. 30(10), pages 815-826, August.
    17. David B. Evans & Dan Chisholm & Tessa Tan-Torres Edejer, 2012. "Generalized Cost-effectiveness Analysis: Principles and Practice," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 48, Edward Elgar Publishing.
    18. Baltussen, Rob & Youngkong, Sitapon & Paolucci, Francesco & Niessen, Louis, 2010. "Multi-criteria decision analysis to prioritize health interventions: Capitalizing on first experiences," Health Policy, Elsevier, vol. 96(3), pages 262-264, August.
    19. Rob Baltussen & Elly Stolk & Dan Chisholm & Moses Aikins, 2006. "Towards a multi‐criteria approach for priority setting: an application to Ghana," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 689-696, July.
    20. Xiaohui Zeng & Jianhe Li & Liubao Peng & Yunhua Wang & Chongqing Tan & Gannong Chen & Xiaomin Wan & Qiong Lu & Lidan Yi, 2014. "Economic Outcomes of Maintenance Gefitinib for Locally Advanced/Metastatic Non-Small-Cell Lung Cancer with Unknown EGFR Mutations: A Semi-Markov Model Analysis," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-9, February.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0055917. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.