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Crizotinib versus chemotherapy: a real-world cost-effectiveness study in China.
- Source :
-
Journal of comparative effectiveness research [J Comp Eff Res] 2020 Jan; Vol. 9 (2), pp. 93-102. Date of Electronic Publication: 2020 Jan 21. - Publication Year :
- 2020
-
Abstract
- Aim: To assess the cost-effectiveness of crizotinib verses platinum-based doublet chemotherapy as the first-line treatment for anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC) in the real-world setting. Methods: Data from 163 advanced ALK positive NSCLC patients were collected from West China Hospital, Sichuan University (Chengdu, China). They were categorized into two groups as treated with crizotinib (n = 83) or chemotherapy (n = 80) as a first-line therapy. The progression-free survival (PFS) as the primary clinical outcome, and the direct medical costs were collected from hospital information systems. Incremental cost-effectiveness ratio (ICER) was calculated with costs, quality-adjusted life-years, as well as the costs discounted at 3% annually. Additionally, two different kinds of medical insurance (MI) for pharma-economic assessment were considered. Results: Crizotinib improved PFS versus chemotherapy in ALK positive patients (median PFS 19.67 m vs 5.47 m; p < 0.001). Moreover, crizotinib obtained an ICER of US$36,285.39 before the end of 2016, when crizotinib, pemetrexed and anti-angiogenesis drugs were not MI covered. This is more than the willingness to pay threshold (three-times of gross domestic product per capita in mainland China or Sichuan Province). However, ICER was US$7321.16, which is less than willingness to pay, when crizotinib and all chemotherapy drugs were covered by MI from the end of 2016. Sensitivity analysis demonstrated a 99.7% probability for crizotinib to be more cost-effective than chemotherapy, when crizotinib and all anticancer drugs were MI covered. One-way sensitivity analysis for the reimbursement ratio of crizotinib indicated that cost-effective tendency for crizotinib increased as reimbursement ratio increased. Conclusion: Crizotinib could be an effective, and cost-effective first-line treatment for ALK positive advanced NSCLC with the MI coverage currently available in Chengdu, Sichuan Province, China.
- Subjects :
- Adult
Aged
Anaplastic Lymphoma Kinase
Antineoplastic Agents adverse effects
China
Cost-Benefit Analysis
Crizotinib adverse effects
Female
Humans
Male
Middle Aged
Models, Econometric
Neoplasm Staging
Progression-Free Survival
Quality-Adjusted Life Years
Antineoplastic Agents economics
Antineoplastic Agents therapeutic use
Carcinoma, Non-Small-Cell Lung drug therapy
Crizotinib economics
Crizotinib therapeutic use
Lung Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2042-6313
- Volume :
- 9
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of comparative effectiveness research
- Publication Type :
- Academic Journal
- Accession number :
- 31958984
- Full Text :
- https://doi.org/10.2217/cer-2019-0075