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Model-Based Economic Evaluation of Ceritinib and Platinum-Based Chemotherapy as First-Line Treatments for Advanced Non-Small Cell Lung Cancer in China

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Abstract

Introduction

A trial-based assessment was completed to evaluate the cost-effectiveness of ceritinib as a first-line treatment for advanced non-small cell lung cancer (NSCLC) with rearrangement of anaplastic lymphoma kinase.

Methods

Based on the disease situation of advanced NSCLC, a Markov model was constructed to estimate the costs and benefits of ceritinib and platinum-based chemotherapy. The cost information and health utilities were obtained from published literature. The incremental cost-effectiveness ratio was calculated. The stability of the model was verified by sensitivity analyses.

Results

The base case analysis results indicated that compared with platinum-based chemotherapy, ceritinib therapy would increase benefits in a 5-, 10- and 15-year time horizon, with extra costs of $230,661.61, $149,321.52 and $136,414.43 per quality-adjusted life-year gained, respectively. The most sensitive parameter in the model analysis was the cost of ceritinib. Probabilistic sensitivity analysis suggested that at the current price of ceritinib, the chance of ceritinib being cost-effective was 0 at the willingness-to-pay threshold of $27,142.85 per quality-adjusted life-year (three times the per capita gross domestic product of China).

Conclusion

As a first-line treatment for advanced NSCLC with rearrangement of anaplastic lymphoma kinase, ceritinib is unlikely to be cost-effective at the current price from the Chinese healthcare perspective. To meet the treatment demands of patients, it may be a better option to reduce the price or provide appropriate drug assistance policies.

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Acknowledgements

Funding

This work and associated journal article processing charges were supported by the National Natural Science Foundation of China (grant numbers 81401547, 81603081); and the Key Science-Technology Research and Development Program of Hunan Province (grant number 2016JC2062). All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Ye Peng, Fang Ma, Chongqing Tan, Xiaomin Wan, Lidan Yi, Liubao Peng and Xiaohui Zeng have nothing to disclose.

Compliance with Ethics Guidelines

Because our economic evaluation was based on a mathematical model to simulate the patient’s lifetime, it did not require the approval of the independent ethics committee. This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Author information

Author notes

  1. Ye Peng and Fang Ma contributed equally to this work.

Authors and Affiliations

  1. Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China

    Ye Peng, Chongqing Tan, Xiaomin Wan, Lidan Yi & Liubao Peng

  2. Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China

    Fang Ma

  3. PET-CT Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China

    Xiaohui Zeng

Authors
  1. Ye Peng
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Correspondence to Liubao Peng or Xiaohui Zeng.

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Peng, Y., Ma, F., Tan, C. et al. Model-Based Economic Evaluation of Ceritinib and Platinum-Based Chemotherapy as First-Line Treatments for Advanced Non-Small Cell Lung Cancer in China. Adv Ther 36, 3047–3058 (2019). https://doi.org/10.1007/s12325-019-01103-4

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  • DOI: https://doi.org/10.1007/s12325-019-01103-4

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