Cost-effectiveness of atezolizumab plus chemotherapy for advanced non-small-cell lung cancer

Shen, Lin; Luo, Shaohong; Zhong, Lixian; Lai, Shubin; Zeng, Dayong; Rao, Xin; Huang, Pinfang; Weng, Xiuhua

doi:10.1007/s11096-020-01076-3

Cited by 39 publications

(40 citation statements)

References 31 publications

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“…These results indicated that first-line treatment with ABCP was not a cost-effective treatment option for metastatic NSCLC in the United States. Cost-effectiveness analysis based on IMpower130 trial data have also shown that the addition of atezolizumab to carboplatin plus nab-paclitaxel is not an economically preferred treatment compared with chemotherapy for first-line treatment of NSCLC patients from a value standpoint in both the United States (36,37) and China (38). Although atezolizumab combination therapy has clinical benefit, it is unlikely to be cost-effective for NSCLC patients compared to chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Atezolizumab compared to chemotherapy for first-line treatment in non-small cell lung cancer with high PD-L1 expression: a cost-effectiveness analysis from US and Chinese perspectives

Cheng

Pei

et al. 2021

Ann Transl Med

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Background: The IMpower110 trial revealed that atezolizumab treatment had significantly longer overall survival (OS) than chemotherapy in non-small cell lung cancer (NSCLC) patients with high-programmed death ligand 1 (PD-L1) expression. The purpose of the present study was to estimate the cost-effectiveness of atezolizumab versus platinum-based chemotherapy for first-line treatment in metastatic NSCLC with high PD-L1 expression, from the perspective of US and Chinese payers.Methods: A partitioned survival model was constructed based on information from the IMpower110 clinical trial to estimate cost-effectiveness of atezolizumab versus chemotherapy as first-line treatment of metastatic NSCLC. Costs were estimated from US and Chinese payer perspectives. The impact of uncertainty was explored by performing one-way and probabilistic sensitivity analyses.

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Section: Discussionmentioning

confidence: 99%

Atezolizumab compared to chemotherapy for first-line treatment in non-small cell lung cancer with high PD-L1 expression: a cost-effectiveness analysis from US and Chinese perspectives

Cheng

Pei

et al. 2021

Ann Transl Med

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“…Additionally, the survival status of cancer patients changes over time, and it is therefore very important for economic analyses to appropriately simulate the survival status. 29 , 30 The Kaplan–Meier survival curve can reflect the changes in the survival state over a period of time, but it is difficult to obtain the original data and evaluate the whole life cycle. Kaplan–Meier survival curves can reflect survival changes over time, but it is difficult to extract the original data and evaluate the entire life cycle.…”

Section: Discussionmentioning

confidence: 99%

“…However, no previous studies have investigated the optimal PD‐1/PD‐L1 inhibitor for immunotherapy in NSCLC patients. Additionally, the survival status of cancer patients changes over time, and it is therefore very important for economic analyses to appropriately simulate the survival status 29,30 . The Kaplan–Meier survival curve can reflect the changes in the survival state over a period of time, but it is difficult to obtain the original data and evaluate the whole life cycle.…”

Section: Discussionmentioning

confidence: 99%

Determining the optimal PD‐1/PD‐L1 inhibitors for the first‐line treatment of non‐small‐cell lung cancer with high‐level PD‐L1 expression in China

et al. 2021

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“…The AEs included in the model were those with a severity of grade 3/4 and a frequency ≥5% or a difference of more than 2% between two treatment strategies in CROWN trial. We included hypercholesterolemia, hypertriglyceridemia, edema, and hypertension in the model and obtained the costs of AEs from previous studies (43)(44)(45)(46)(47)(48). The CROWN trial reported the corresponding percentage of the population that received subsequent treatment, but it did not provide a specific protocol for subsequent treatment.…”

Section: Cost and Utility Inputmentioning

confidence: 99%

Cost-Effectiveness of Lorlatinib as a First-Line Therapy for Untreated Advanced Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer

Peng

et al. 2021

Front. Oncol.

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IntroductionRecently, a phase III CROWN trial compared the efficacy of two anaplastic lymphoma kinase (ALK) inhibitors and demonstrated that lorlatinib displayed clinical improvement over crizotinib for advanced non-small cell lung cancer (NSCLC) patients. Therefore, the aim of this study was to estimate the cost-effectiveness of lorlatinib as a first-line therapy for patients with advanced ALK-positive (+) NSCLC.Materials and MethodsA cost-effectiveness analysis was performed using a microsimulation model from the US payer perspective and a lifetime horizon (30 years) in patients with previous untreated advanced ALK+ NSCLC. Based on the CROWN trial, patient characteristics were obtained, and the transition probabilities were estimated. All direct costs were derived from official sources and published literature. The main outcomes of the model were total costs, incremental cost-effectiveness ratio (ICER), quality-adjusted life years (QALYs), and life years (LYs). One-way and probabilistic sensitivity analyses and multiple scenario analyses were conducted to test the robustness of the model outcomes.ResultsIn the base case analysis, in which 1 million patients were simulated, treatment with lorlatinib or crizotinib as the first-line treatment was related to a mean cost of $909,758 and $616,230 (incremental cost: $293,528) and a mean survival of 4.81 QALYs and 4.09 QALYs (incremental QALY: 0.72) per patient, respectively. The main drivers of cost effectiveness were drug price and subsequent cost. PAS indicated that lorlatinib has 90% cost-effectiveness when compared to crizotinib when the willingness-to-pay (WTP) threshold in increased to $448,000/QALY. Scenario analysis demonstrated that lorlatinib has 100% cost-effectiveness at a WTP threshold of 200,000/QALY compared to crizotinib treatment when the price of lorlatinib is decreased to 75% ($424.5) of its original price.ConclusionsIn this study, lorlatinib was unlikely to be cost effective compared with crizotinib for patients with previously untreated advanced ALK+ NSCLC at a WTP threshold of 200,000/QALY.

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Cost-effectiveness of atezolizumab plus chemotherapy for advanced non-small-cell lung cancer

Cited by 39 publications

References 31 publications

Atezolizumab compared to chemotherapy for first-line treatment in non-small cell lung cancer with high PD-L1 expression: a cost-effectiveness analysis from US and Chinese perspectives

Atezolizumab compared to chemotherapy for first-line treatment in non-small cell lung cancer with high PD-L1 expression: a cost-effectiveness analysis from US and Chinese perspectives

Determining the optimal PD‐1/PD‐L1 inhibitors for the first‐line treatment of non‐small‐cell lung cancer with high‐level PD‐L1 expression in China

Cost-Effectiveness of Lorlatinib as a First-Line Therapy for Untreated Advanced Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer

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