Lorlatinib as a first-line treatment of adult patients with anaplastic lymphoma kinase-positive advanced non-small cell lung cancer: Α cost-effectiveness analysis in Greece

ABSTRACT

Objectives

To evaluate the cost-effectiveness of lorlatinib compared to 1^st generation anaplastic lymphoma kinase (ALK) TKI crizotinib, and 2^nd generation TKIs alectinib and brigatinib, for previously untreated patients with ALK+ advanced Non-Small Cell Lung Cancer (aNSCLC).

Methods

A partitioned survival model was locally adapted from a Greek payer perspective over a lifetime horizon. Clinical, safety and utility data were extracted from literature. Direct medical costs reflecting the year 2023 were included in the analysis (€). Model outcomes were patients’ life years (LYs), quality-adjusted life years (QALYs), total costs and incremental cost-effectiveness ratios (ICERs).

Results

Total cost per patient with lorlatinib, alectinib, crizotinib, and brigatinib was estimated to be €188,205, €183,343, €75,028, and €145,454 respectively. Lorlatinib appeared to yield more LYs and QALYs gained versus alectinib, crizotinib, and brigatinib. Hence, lorlatinib resulted in ICERs of €4,315 per LY gained and €4,422 per QALY gained compared to alectinib, €34,032 per LY gained and €48,256 per QALY gained versus crizotinib and €16,587 per LY gained and €26,271 per QALY gained compared to brigatinib.

Conclusion

Lorlatinib provides substantial clinical benefit and appears to be a cost – effective treatment option compared to 1^st and 2^nd generation TKIs for previously untreated patients with ALK+ aNCSLC in Greece.

KEYWORDS:

• Cost-effectiveness
• anaplastic lymphoma kinase
• non-small cell lung cancer
• first-line treatment
• Greece

Article highlights

• The aim of the present study was to evaluate the cost-effectiveness of lorlatinib as a first-line treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced Non-Small Cell Lung Cancer (ALK+ aNCSLC) in Greece.

• A published partitioned survival model with four health states was locally adapted from a Greek payer perspective over a lifetime horizon.

• The results indicate that lorlatinib provides substantial clinical benefit and appears to be a cost – effective treatment option compared to 1^st and 2^nd generation ALK TKIs for previously untreated patients with ALK+ aNCSLC in Greece.

Availability of data and materials

All data used to conduct this study are included in this published article.

Acknowledgments

The authors thank Hannah Le and Despina Thomaidou of Pfizer for their contribution in the present manuscript.

Declaration of interest

G. Gourzoulidis and C.Tzanetakos received consulting fees from Pfizer Hellas in connection with the development of this study. O. Zisimopoulou and A.Liavas are Pfizer Hellas employees at the time of the study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Author contributions

Conceived the study: G. Gourzoulidis, O. Zisimopoulou and C.Tzanetakos; Designed the study: G. Gourzoulidis. and C.Tzanetakos; Analysed the data: G. Gourzoulidis; Interpreted the data: G. Gourzoulidis, O. Zisimopoulou, C.Tzanetakos and A.Liavas; Contributed to writing and review of the manuscript: G. Gourzoulidis, O. Zisimopoulou, C.Tzanetakos and A.Liavas All authors approved the final version of the completed manuscript and agreed to be accountable for the entirety of this study.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2288249

Additional information

Funding

This study was sponsored by Pfizer Hellas.