Cost-effectiveness of osimertinib versus standard EGFR-TKI as first-line treatment for locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia.

Khoo, T; Gao, L

Cost-effectiveness of osimertinib versus standard EGFR-TKI as first-line treatment for locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia.

Khoo, T

Gao, L

Permalink

Publisher:: TAYLOR & FRANCIS LTD
Publication Type:: Journal Article
Citation:: Expert review of pharmacoeconomics & outcomes research, 2020, pp. 1-9
Issue Date:: 2020-12-06

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

The embargo period expires on 20 Dec 2021

Adobe PDF

Download full textAdobe PDF (2.22 MB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Khoo, T https://orcid.org/0000-0002-6765-7889
dc.contributor.author	Gao, L
dc.date.accessioned	2021-02-04T02:08:52Z
dc.date.available	2021-02-04T02:08:52Z
dc.date.issued	2020-12-06
dc.identifier.citation	Expert review of pharmacoeconomics & outcomes research, 2020, pp. 1-9
dc.identifier.issn	1473-7167
dc.identifier.issn	1744-8379
dc.identifier.uri	http://hdl.handle.net/10453/145798
dc.description.abstract	<b>Objectives</b>: To assess the cost-effectiveness of osimertinib versus standard epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), gefitinib or erlotinib, as first-line treatment for patients with locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia from a healthcare system perspective. <b>Methods</b>: A partitioned survival model comprising three mutually exclusive health states with a five-year time horizon was developed. Model inputs were sourced from the pivotal trial (FLAURA) and published literature. Incremental cost-effectiveness ratios (ICERs), in terms of cost per quality-adjusted life-year (QALY) gained and cost per life-year (LY) gained, were calculated. Uncertainty of the results was assessed using deterministic and probabilistic sensitivity analyses. <b>Results</b>: Compared with standard EGFR-TKIs, osimertinib was associated with a higher incremental cost of A$118,502, and an incremental benefit of 0.274 QALYs and 0.313 LYs. The ICER was estimated to be A$432,197/QALY gained and A$378,157/LY gained. The base-case ICER was most sensitive to changes in cost of first-line osimertinib, time horizon, and choice of overall survival data (interim versus final analysis). <b>Conclusions</b>: At a willingness-to-pay threshold of A$50,000/QALY, first-line osimertinib is not cost-effective compared with standard EGFR-TKIs in Australia based on the current published price. To achieve acceptable cost-effectiveness, the cost of first-line osimertinib needs to be reduced by at least 68.4%.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	TAYLOR & FRANCIS LTD
dc.relation.ispartof	Expert review of pharmacoeconomics & outcomes research
dc.relation.isbasedon	10.1080/14737167.2021.1847648
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject	1115 Pharmacology and Pharmaceutical Sciences, 1117 Public Health and Health Services, 1402 Applied Economics
dc.subject.classification	Health Policy & Services
dc.title	Cost-effectiveness of osimertinib versus standard EGFR-TKI as first-line treatment for locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia.
dc.type	Journal Article
utslib.location.activity	England
utslib.for	1115 Pharmacology and Pharmaceutical Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
utslib.copyright.embargo	2021-12-20T00:00:00+1000Z
dc.date.updated	2021-02-04T02:08:46Z
pubs.publication-status	Published

Abstract:

Objectives: To assess the cost-effectiveness of osimertinib versus standard epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), gefitinib or erlotinib, as first-line treatment for patients with locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia from a healthcare system perspective. Methods: A partitioned survival model comprising three mutually exclusive health states with a five-year time horizon was developed. Model inputs were sourced from the pivotal trial (FLAURA) and published literature. Incremental cost-effectiveness ratios (ICERs), in terms of cost per quality-adjusted life-year (QALY) gained and cost per life-year (LY) gained, were calculated. Uncertainty of the results was assessed using deterministic and probabilistic sensitivity analyses. Results: Compared with standard EGFR-TKIs, osimertinib was associated with a higher incremental cost of A$118,502, and an incremental benefit of 0.274 QALYs and 0.313 LYs. The ICER was estimated to be A$432,197/QALY gained and A$378,157/LY gained. The base-case ICER was most sensitive to changes in cost of first-line osimertinib, time horizon, and choice of overall survival data (interim versus final analysis). Conclusions: At a willingness-to-pay threshold of A$50,000/QALY, first-line osimertinib is not cost-effective compared with standard EGFR-TKIs in Australia based on the current published price. To achieve acceptable cost-effectiveness, the cost of first-line osimertinib needs to be reduced by at least 68.4%.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/145798