Cost-effectiveness of first-line erlotinib in patients with advanced non-small-cell lung cancer unsuitable for chemotherapy

Khan, Iftekhar; Morris, Stephen; Hackshaw, Allan; Lee, Siow Ming

doi:10.1136/bmjopen-2014-006733

Cited by 19 publications

(11 citation statements)

References 31 publications

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“…Only two studies were based on decision trees without a Markov component 16,17 and four were adopted from the same partitioned survival model with three health states. [18][19][20][21] Another five studies [22][23][24][25][26] were found that reported no economic model.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Less than half (48%) of publications reviewed were thus classified as high quality, and three studies (14.3%) are of poor quality, 22,24,25 while the average score of the selected studies was 71.52. The source of utility values that all selected studies extracted were also evaluated, and 17 out of 25 papers used values obtained from previously published literature, five studies derived utility data from EQ-5D or another quality of life survey, [17][18][19]23,32 and three studies used survival data from a single medical institution 16 or clinical trials. 20,21 A pairwise comparison demonstrated that there was no statistically significant difference between the results of the CHEERS and QHES instruments, p=0.51, illustrated in Figure 3.…”

Section: Articles Identified Through Database Search N=506mentioning

confidence: 99%

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<p>A Systematic Review of Health Economic Evaluation on Targeted Therapies for First-Line Treatment of Metastatic Non-Small Cell Lung Cancer (NSCLC): Quality Evaluation</p>

Zhao¹,

Du²,

Zhu³

et al. 2020

CMAR

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Background: Evolving practices in non-small cell lung cancer (NSCLC) therapy inevitably affect health care budgets, especially through the introduction of targeted therapies. This results in a rise of health economic evaluations (HEEs) in this domain. This article reviews the quality of the economic evidence of targeted therapies used in metastatic NSCLC. Methods: A literature search was conducted using PubMed, Cochrane, Embase and CRD (University of York Centre for Reviews and Dissemination) databases to identify topical original articles published between 1/1/2000 and 3/31/2019. A quality of reporting assessment using the CHEERS (Consolidated Health Economic Evaluation Reporting Standards statement) checklist was converted into a quantitative score and compared with the results of a QHES (Quality of Health Economic Studies) evaluation. Components of QHES were also used to analyze the validity of primary outcomes, consideration of heterogeneity and rationality of main assumptions of models in modeling studies. Results: In total, 25 HEEs were obtained and analyzed. From the CHEERS assessment, it was found that method description integrity (including setting, perspective, time horizon and discount rate), justification of data sources and a heterogeneity description were often absent or incomplete. Only five examined studies met the accepted standard of good quality. Modeled articles were examined with the QHES instrument, and a lack of illustrated structure, population variability, formula of the transitioning probability and justification for the choice of the model were the most frequently observed problems in the selected studies. After quantification, the CHEERS scores and QHES scores did not differ significantly. Conclusion: Current NSCLC models generally lack consideration for demographic heterogeneity and transparency of data description, and it would be difficult to transfer or generalize from the scientific literature to real-world evidence-based decision-making. Frameworks of future models should be informed and justified based on the validity of model results and the improvement of modeling accuracy.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Articles Identified Through Database Search N=506mentioning

confidence: 99%

<p>A Systematic Review of Health Economic Evaluation on Targeted Therapies for First-Line Treatment of Metastatic Non-Small Cell Lung Cancer (NSCLC): Quality Evaluation</p>

Zhao¹,

Du²,

Zhu³

et al. 2020

CMAR

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“…It is reported that lung cancer is responsible for more deaths than a combination of those caused by colorectal cancer, breast cancer, and prostate cancer. [ 1 ] Non-small-cell lung cancer (NSCLC) is the main origin of cancer-related death, and 85% or more patients are diagnosed with NSCLC at an advanced stage. [ 2 ] Chemotherapy plus radiotherapy has been reported to be one of the most effective treatment options against NSCLC in the previous study.…”

Section: Introductionmentioning

confidence: 99%

Risk of rash associated with vandetanib treatment in non-small-cell lung cancer patients

Liu

Qi²,

Hou³

et al. 2017

Medicine

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Background:Vandetanib is a promising anticancer target agent for treating advanced carcinomas, such as non-small-cell lung cancer (NSCLC) and breast cancer. Rash is a frequently reported adverse event of vandetanib. We conducted this meta-analysis to determine the incidence rate and overall risks of all-grade and high-grade rash with vandetanib in NSCLC patients.Methods:PubMed, Embase, Web of Science, American Society of Clinical Oncology, and Cochrane Library were systematically searched to identify studies with vandetanib and rash in NSCLC patients. Data were extracted to calculate the pooled incidence of all-grade and high-grade (grade ≥3) rash caused by vandetanib treatment.Results:Nine randomized controlled trials involving 4893 patients met the inclusion criteria and were included in this meta-analysis. The overall incidence of all-grade and high-grade rash caused by vandetanib treatment was 46% (95% CI: 37.1%, 54.8%), and 3.2% (95% CI: 1.4%, 5.1%), respectively. The risk ratios (RR) of all-grade and high-grade rash for vandetanib treatment versus control treatment were 2.35 (95% CI: 1.20, 4.61; P < .001) and 4.68 (95% CI 1.42, 15.37; P < .001), respectively. Subgroup analysis suggested that the increased risk of all-grade rash was clear across all subgroups, including first-line/second-line therapy, phase 2/phase 3 trial, sample size 200, a dosage of 100 or 300 mg, and monotherapy/combination therapy. However, for the high-grade rash, vandetanib did not increase the risk of rash when it was used in first-line therapy, or in a phase II trial, or in a trial with sample size <200.Conclusions:This study suggests that vandetanib was associated with a significantly increased risk of rash. Therefore, early recognition and appropriate monitoring should be taken when NSCLC patients were treated with vandetanib.

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“…The pharmacoeconomic analysis implies a competitive comparative approach, and there is a problem of choosing a comparison technology for the pharmacoeconomic evaluation of the drug. An analysis of practical experience with pharmacoeconomics shows [1-12, [16][17][18][19][20][21][22][23][24][25][26][27] that the following options are traditionally chosen as comparison technologies:…”

mentioning

confidence: 99%

Selection of a comparison technology for pharmacoeconomic analysis of innovative drugs

Yagudina¹,

Serpik²,

Krylov³

et al. 2017

Pharmacoeconom T&P

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This publication discusses the problem of choosing a comparison technology for pharmacoeconomic analysis. The relevance of this issue stems from the fact that the pharmacoeconomic analysis is based on a comparative competitive approach and that the comparison technology sets the point of reference and determines the sensitivity of the assessment. Pharmacoeconomic assessment is most needed for innovative drugs. In this context, the choice of comparison technology predetermines the results of the pharmacoeconomic evaluation of an innovative drug. The traditional approach used in choosing a comparison technology in a pharmacoeconomic analysis based on the evidence of medical use between the drug being investigated and the comparison technology has some limitations, especially when the drug of a new class is evaluated. In this case, the comparison technology often uses long-running medications, which are not comparable with the innovative drug, either in terms of efficiency (usually to a large extent) or at the cost of an innovative drug, which is often more high-priced. In these circumstances, the results of the pharmacoeconomic assessment of innovative drug will possibly be negative. The negative results may be a sign of not likely unacceptability of an innovative drug but the consequence of the incorrect choice of comparison technology, which sets the level of sensitivity of the pharmacoeconomic analysis, in which the innovation drug is known to be beyond its borders. For a solution to the situation, the authors suggest an alternative approach to the choice of comparison technology in the pharmacoeconomic analysis.

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Cost-effectiveness of first-line erlotinib in patients with advanced non-small-cell lung cancer unsuitable for chemotherapy

Cited by 19 publications

References 31 publications

<p>A Systematic Review of Health Economic Evaluation on Targeted Therapies for First-Line Treatment of Metastatic Non-Small Cell Lung Cancer (NSCLC): Quality Evaluation</p>

<p>A Systematic Review of Health Economic Evaluation on Targeted Therapies for First-Line Treatment of Metastatic Non-Small Cell Lung Cancer (NSCLC): Quality Evaluation</p>

Risk of rash associated with vandetanib treatment in non-small-cell lung cancer patients

Selection of a comparison technology for pharmacoeconomic analysis of innovative drugs

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