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Cost-effectiveness of trifluridine/tipiracil (TAS102) for heavily pretreated metastatic gastric cancer

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Abstract

Background and aim

Trifluridine/tipiracil (TAS102), a novel oral cytotoxic chemotherapy, significantly improved overall survival compared with placebo in heavily pretreated advanced gastric cancer. This study aimed to evaluate the cost-effectiveness of TAS102 in the third-line or later treatment for this population from the US payer perspective.

Methods

A Markov model was developed to simulate advanced gastric cancer, including three health states: progression-free survival (PFS), progressive disease (PD) and death. Model inputs were derived from a randomised, double-blind, placebo-controlled, phase 3 trial (TAGS trial, NCT02500043). Utilities were extracted from public resources. Costs were calculated from an American payer perspective. Sensitivity analyses were conducted to explore the impact of uncertainty.

Results

From the US payer perspective, treatment with TAS102 for patients with heavily pretreated advanced gastric cancer was estimated to increase costs by $59,180 compared with the placebo, with a gain of 0.06 quality-adjusted life years (QALYs) for an incremental cost-effectiveness ratio (ICER) of $986,333 per QALY. The costs for progression-free survival of TAS102 group had the greatest impact on the ICERs, as well as the cost of TAS102.

Conclusion

Trifluridine/tipiracil (TAS102) is not a cost-effective choice for patients with heavily pretreated metastatic gastric cancer from an American payer perspective.

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Acknowledgements

This study was funded by the National Natural Science Foundation of China (No. 81572988); Science & Technology Department of Sichuan Province Funding Project (No. 2016FZ0108, 2018SZ0117).

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Authors and Affiliations

  1. Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37, GuoXue Xiang, Chengdu, 610041, Sichuan, China

    K. Zhou, J. Zhou, M. Zhang, W. Liao & Q. Li

  2. West China Biomedical Big Data Center, Sichuan University, No. 37, GuoXue Xiang, Chengdu, 610041, Sichuan, China

    K. Zhou, J. Zhou, M. Zhang, W. Liao & Q. Li

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  1. K. Zhou
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  2. J. Zhou
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  3. M. Zhang
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  4. W. Liao
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  5. Q. Li
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Correspondence to Q. Li.

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Informed consent was obtained from all individual participants included in the study.

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Zhou, K., Zhou, J., Zhang, M. et al. Cost-effectiveness of trifluridine/tipiracil (TAS102) for heavily pretreated metastatic gastric cancer. Clin Transl Oncol 22, 337–343 (2020). https://doi.org/10.1007/s12094-019-02127-6

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  • DOI: https://doi.org/10.1007/s12094-019-02127-6

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