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C. Chouaid
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P3.07 - Poster Session with Presenters Present (ID 493)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Regional Aspects/Health Policy/Public Health
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.07-003 - Effectiveness of Pemetrexed in Advanced Non-Squamous NSCLC and Estimation of Its Impact on Public Health in France (ID 4623)
14:30 - 14:30 | Author(s): C. Chouaid
- Abstract
Background:
Changes to national reimbursement criteria in France may limit patient access to pemetrexed. In the absence of head-to-head comparative clinical trials, we compared outcomes for various induction–maintenance (I–M) sequences used in advanced non-squamous (nsq) non-small cell lung cancer (NSCLC) in France. We estimated the impact of not treating with pemetrexed, compared with current French practice, in terms of life-years (LYs) and quality-adjusted life-years (QALYs).
Methods:
Progression-free survival (PFS) and overall survival (OS) of I–M sequences used in French clinical practice were assessed following literature review and network meta-analysis using a sequential decision analytic model adapted for the French healthcare setting. LYs and QALYs (using French EQ5D values) were estimated and compared for sequences with and without pemetrexed. Conservative assumptions were made for missing data. First-line treatment pattern data were taken from the overall European FRAME prospective observational study cohort (Moro-Sibilot. Lung Cancer 2015). The target population for first-line pemetrexed therapy was derived from a French National Authority for Health Pemetrexed Assessment Report (HAS 2016).
Results:
In the base case, the I–M sequence pemetrexed+cisplatin→pemetrexed was associated with the longest median PFS and OS (5.98 and 12.88 months, respectively) and highest LYs and QALYs (1.37 and 0.93, respectively) (Table). LYs and QALYs were higher for all comparators when pemetrexed rather than best supportive care was used as maintenance. By weighting treatment sequences by FRAME treatment patterns, not using pemetrexed in this setting yielded overall losses of 1232–1314 LYs and 922–983 QALYs each year in France. Figure 1
Conclusion:
According to the results of this modelled analysis, compared with current French practice, limiting access to pemetrexed for the I–M treatment of patients with advanced nsqNSCLC could result in substantial loss of LYs and QALYs in this population.
