Author of

• 12095

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  O16 - NSCLC - Targeted Therapies III (ID 115)

  • Event: WCLC 2013
  • Type: Oral Abstract Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:H.A. Wakelee, L. Crino
  • Coordinates: 10/29/2013, 10:30 - 12:00, Parkside Auditorium, Level 1

  • 12098

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    O16.03 - Cost-utility analysis of first-line treatment with erlotinib versus chemotherapy in EGFR-mutant advanced non-small-cell lung cancer (NSCLC): economic analysis of EURTAC trial (ID 1100)

    10:50 - 11:00  |  Author(s): R. Palmero
    • Abstract
    • Presentation
    • Slides

    Background
    The impact of tyrosine kinase inhibitors (TKIs) in EGFR-mutant advanced NSCLC is poorly documented. Two studies (Jacob et al, ISPOR2010, Brown et al, Health Technol Assess, 2010) are based on modelisation and indirect comparisons. The present study reports a cost-utility analysis of a phase III randomized trial (EURTAC).

    Methods
    A three state Markov model (first line PFS, second line PD and death) was built. Clinical data and resource assessment (drugs, drug administration, adverse events, second-line treatment) were collected from the trial. Utility values were derived from Nafees et al, as previously published (Vergnenegre et al. JTO 2011). Incremental cost-utility ratios (ICUR) were calculated for the first-line treatment and the overall strategy until death from the perspective of different countries (2013 actualized euros). Sensitivity analyses researched the main cost drivers.

    Results
    The quality-adjusted life-years gained was 0.124 with erlotinib, which showed an improvement in the quality of life for these patients. Despite the extra treatment costs of second-line erlotinib in the chemotherapy arm, there was a cost benefit for erlotinib first, resulting in fewer patients receiving second-line pemetrexed along with other therapy. Cost gain in favor of first-line erlotinib was 8,918 Euros. The main results are depicted in Table1.

    	First-line erlotinib	First-line chemotherapy
    Average cost of first-line (euros 2013)
    Drugs	21,679	1030
    Administration	329	4,455
    Adverse events	546	2,686
    Cost of post-first progression care	40,467	67,281
    ICUR (erlotinib versus chemotherapy)
    ICUR France		negative
    ICUR Spain		negative
    ICUR Italy		negative

    Sensitivity analyses will be presented at the meeting.

    Conclusion
    ICUR favored first-line erlotinib in EGFR-mutant patients with advanced NSCLC, which is the widely accepted treatment compared to chemotherapy. The cost-utility of the overall strategy remained beneficial in three different European countries. On behalf GFCP,GEPC and AIOT groups

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