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Abstract
Objective
The aim of this study was to evaluate the cost-effectiveness of gefitinib plus chemotherapy (GCP) versus gefitinib alone for advanced non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations in China.
Methods
A decision-analytic Markov model was conducted to simulate the disease process of advanced NSCLC patients with EGFR mutations. Three distinct health states: progression-free survival (PFS), progressive disease (PD) and death were included. Clinical data were derived from the NEJ009 study. The cost was evaluated from the perspective of the Chinese society. Quality-adjusted life-years (QALYs) and incremental cost–effectiveness ratios (ICER) were calculated over a 10-year lifetime horizon. One-way sensitivity analysis and probabilistic sensitivity analysis were also performed to explore the uncertainty of parameters in the study.
Results
The base case analysis demonstrated that gefitinib plus chemotherapy gained 2.44 QALYs at an average cost of $59,571.34, while the effectiveness and cost of gefitinib group were 1.82 QALYs and $52,492.75, respectively. The ICER for gefitinib plus chemotherapy was $11,499.98 per QALY gained. The ICER was lower than the accepted willingness-to-pay (WTP) threshold, which was three times gross domestic product (GDP) per capita of China ($31,498.70 per QALY). Variation of parameters did not reverse the cost-effectiveness of gefitinib plus chemotherapy through univariable and probabilistic sensitivity analyses.
Conclusion
Our results showed that gefitinib plus chemotherapy is a cost-effective treatment option compared with gefitinib for advanced NSCLC patients with EGFR mutations in China.
Ethical Approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors have indicated that they have no conflicts of interest regarding the content of this article.