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 : HEPAC : Health Economics in Prevention and Care
Oscar ArrietaAna C Polanco

Abstract

Assess the cost-effectiveness of an EGFR-mutation testing strategy for advanced NSCLC in first-line therapy with either gefitinib or carboplatin-paclitaxel in Mexican institutions. Cost-effectiveness analysis using a discrete event simulation (DES) model to simulate two therapeutic strategies in patients with advanced NSCLC. Strategy one included patients tested for EGFR-mutation and therapy given accordingly. Strategy two included chemotherapy for all patients without testing. All results are presented in 2014 US dollars. The analysis was made with data from the Mexican frequency of EGFR-mutation. A univariate sensitivity analysis was conducted on EGFR prevalence. Progression-free survival (PFS) transition probabilities were estimated on data from the IPASS and simulated with a Weibull distribution, run with parallel trials to calculate a probabilistic sensitivity analysis. PFS of patients in the testing strategy was 6.76 months (95 % CI 6.10-7.44) vs 5.85 months (95 % CI 5.43-6.29) in the non-testing group. The one-way sensitivity analysis showed that PFS has a direct relationship with EGFR-mutation prevalence, while the ICER and testing cost have an inverse relationship with EGFR-mutation prevalence. The probabilistic sensit...Continue Reading

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Citations

Mar 5, 2016·Mediators of Inflammation·Mario Orozco-MoralesOscar Arrieta
Oct 21, 2016·Expert Opinion on Drug Safety·Feliciano BarronOscar Arrieta
Jan 31, 2019·Journal of Managed Care & Specialty Pharmacy·Fahim FaruqueEberechukwu Onukwugha
Mar 17, 2018·The European Respiratory Journal·Sandrine LoubièreUNKNOWN French Cooperative Thoracic Intergroup (IFCT)
Dec 9, 2017·Archives of Pathology & Laboratory Medicine·Mitra MehradSanja Dacic
Sep 29, 2019·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Oscar ArrietaJaime De la Garza

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