Cost-Effectiveness Analysis of Dacomitinib versus Gefitinib in the First-Line Treatment of EGFR-Positive Advanced or Metastatic Non-Small Cell Lung Cancer

Abstract

Background

The objective of the study was to evaluate the economics of dacomitinib and gefitinib in the first-line treatments for EGFR-positive advanced or metastatic non-small cell lung cancer (NSCLC) from a US payer perspective.

Methods

We developed the partition survival model to compare the lifetime cost and health outcomes of dacomitinib versus gefitinib. Transition probabilities were collected from the ARCHER 1050 trial. The model only considered the direct medical costs. Utility values were taken from published research.

Results

Compared to gefitinib, dacomitinib increased 0.706 QALY and the cost increased $232,359.32. The incremental cost-effectiveness ratio (ICER) was $329,120.85 per QALY in the base case. One-way sensitivity analysis showed that the cost of drugs and the utility had more influence on the results than other parameters. Probability sensitivity analysis reflected that the parameters had little effect on the results.

Conclusion

Dacomitinib could improve the health benefits and increase the overall costs. In this simulation, dacomitinib is not likely to be economical for first-line therapy of EGFR-mutated NSCLC.

Keywords:

• dacomitinib
• gefitinib
• cost-effectiveness
• non-small cell lung cancer

Acknowledgment

This work was supported by Fujian Provincial Natural Science Foundation (grant number. 2017J01816 & 2018Y9037), Fujian Provincial Health Commission (grant number 2019-CX-17), and National Natural Science Foundation of China (grant number 71804025).

Disclosure

The authors declare that they have no conflicts of interest.