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Research Article
26 February 2021

Dacomitinib in first-line treatment of advanced EGFR-mutated non-small-cell lung cancer: a cost–effectiveness analysis

Authors: Javier Aguilar-Serra, Vicente Gimeno-Ballester, Alfonso Pastor-Clerigues [email protected], Javier Milara, Ezequiel Marti-Bonmati, Cristina Trigo-Vicente, and Julio CortijoAuthor Info & Affiliations
Volume 10, Number 4
https://doi.org/10.2217/cer-2020-0233
PDFFormats

Abstract

Aim: To assess the cost–effectiveness of first-line treatment with dacomitinib compared with gefitinib in patients newly diagnosed with advanced NSCLC EGFR-positive in the context of Spain. Materials & methods: A partitioned survival model was developed including costs, utilities and disutilities to estimate quality-adjusted life-year (QALY) and incremental cost–effectiveness ratio when treating with dacomitinib versus gefitinib. Results: Dacomitinib presented higher QALYs (0.51) compared with gefitinib (0.45). Dacomitinib costs were €33,061 in comparison with €26,692 for gefitinib arm. An incremental cost–effectiveness ratio of €111,048 was obtained for dacomitinib. Conclusion: Dacomitinib was more effective in terms of QALYs gained than gefitinib. However, to obtain a cost–effectiveness alternative, a discount greater than 25% in dacomitinib acquisition cost is required.

Lay abstract

EGFR tyrosine kinase inhibitors represent the standard of care in patients with EGFR mutation-positive (EGFRm+) non-small-cell lung cancer. The introduction of new oncology therapies can result in financial pressure for healthcare payers. Therefore, the development of a cost–effectiveness study for assessing the gains in health relative to the costs of different health interventions is required. In this study, we compare dacomitinib with gefitinib as first-line treatment from a Spanish National Health System perspective, by estimating how much it costs to gain a unit of a health outcome, like a life year gained or quality-adjusted life-year. Dacomitinib has been proved not to be a cost-effective alternative because despite being more effective in terms of life year gained or quality-adjusted life-year than gefitinib, it was also much more expensive due to the high acquisition cost of dacomitinib.

Supplementary Material

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