Skip to main content
SpringerLink
Log in

Economic Considerations in the Use of Novel Targeted Therapies for Lung Cancer: Review of Current Literature

PharmacoEconomics Aims and scope Submit manuscript

Cite this article

Abstract

Lung cancer remains the leading cause of cancer-related death and economic burden worldwide. Despite the heavy toll of lung cancer, multiple new advances have improved patient outcomes, largely through precision medicine and targeted therapy. The associated rising economic burden however may impact the uptake of novel therapeutic agents in lung cancer, thereby limiting patient access. This article identifies and reviews economic evaluations of targeted agents in lung cancer in the era of precision medicine. Articles evaluating biomarker-directed test-and-treat strategies are also reviewed to evaluate the cost impact of novel therapeutic agents at a population level. The Quality of Health Economic Studies instrument is applied to assess the quality of included studies. Forty-six studies are reviewed and encompass studies of epidermal growth factor receptor inhibitors and monoclonal antibodies, anaplastic lymphoma kinase inhibitors, vascular endothelial growth factor and vascular endothelial growth factor receptor inhibitors and immunotherapy (programmed death-1 inhibitors). Key factors influencing results of economic analyses include comparators chosen, perspective used, magnitude of clinical benefit, utility weighting of outcomes and drug acquisition costs. Biomarker-driven decision making should be integrated into cost evaluations given the important role of molecular testing for individualising treatment for non-small-cell lung cancer. We conclude that despite major clinical advances in lung cancer therapeutics, cost remains an important consideration in the adoption of novel therapies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2014;136:E359–86.

    Article  PubMed  Google Scholar 

  2. John RM. Global economic cost of cancer report. 2010. http://bit.ly/9NTLj6. Accessed 6 Aug 2017.

  3. Sequist LV, Martins RG, Spigel D, Grunberg SM, Spira A, Jänne PA, et al. First-line gefitinib in patients with advanced non-small-cell lung cancer harboring somatic EGFR mutations. J Clin Oncol. 2008;26:2442–9.

    Article  CAS  PubMed  Google Scholar 

  4. Mok TS, Wu Y-L, Thongprasert S, Yang C-H, Chu D-T, Saijo N, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361:947–57.

    Article  CAS  PubMed  Google Scholar 

  5. Goss G, Tsai C-M, Shepherd FA, Bazhenova L, Lee JS, Chang G-C, et al. Osimertinib for pretreated EGFR Thr790Met-positive advanced non-small-cell lung cancer (AURA2): a multicentre, open-label, single-arm, phase 2 study. Lancet Oncol. 2016;17:1643–52.

    Article  CAS  PubMed  Google Scholar 

  6. Brahmer J, Reckamp KL, Baas P, Crinò L, Eberhardt WEE, Poddubskaya E, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med. 2015;373:123–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Borghaei H, Paz-Ares L, Horn L, Spigel DR, Steins M, Ready NE, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med. 2015;373:1627–39.

    Article  CAS  PubMed  Google Scholar 

  8. Garon EB, Rizvi NA, Hui R, Leighl N, Balmanoukian AS, Eder JP, et al. Pembrolizumab for the treatment of non-small-cell lung cancer. N Engl J Med. 2015;372:2018–28.

    Article  PubMed  Google Scholar 

  9. Thatcher N, Hirsch FR, Luft AV, Szczesna A, Ciuleanu TE, Dediu M, et al. Necitumumab plus gemcitabine and cisplatin versus gemcitabine and cisplatin alone as first-line therapy in patients with stage IV squamous non-small-cell lung cancer (SQUIRE): an open-label, randomised, controlled phase 3 trial. Lancet Oncol. 2015;16:763–74.

    Article  CAS  PubMed  Google Scholar 

  10. de Lima Lopes G Jr, Segel JE, Tan DSW, Do YK, Mok T, Finkelstein EA. Cost-effectiveness of epidermal growth factor receptor mutation testing and first-line treatment with gefitinib for patients with advanced adenocarcinoma of the lung. Cancer. 2011;118:1032–9.

    Article  PubMed  Google Scholar 

  11. Hoch JS, Sabharwal M. Informing Canada’s cancer drug funding decisions with scientific evidence and patient perspectives: the Pan-Canadian Oncology Drug Review. Curr Oncol. 2013;20:121–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Chabot I, Rocchi A. Oncology drug health technology assessment recommendations: Canadian versus UK experiences. Clinicoecon Outcomes Res. 2014;6:357–67.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Nadler E, Eckert B, Neumann PJ. Do oncologists believe new cancer drugs offer good value? Oncologist. 2006;11:90–5.

    Article  PubMed  Google Scholar 

  14. Handorf EA, McElligott S, Vachani A, Langer CJ, Bristol Demeter M, Armstrong K, et al. Cost effectiveness of personalized therapy for first-line treatment of stage IV and recurrent incurable adenocarcinoma of the lung. J Oncol Pract. 2012;8:1–11.

    Article  Google Scholar 

  15. Ofman JJ, Sullivan SD, Neumann PJ, Chiou C-F, Henning JM, Wade SW, et al. Examining the value and quality of health economic analyses: implications of utilizing the QHES. J Manag Care Pharm. 2003;9:53–61.

    PubMed  Google Scholar 

  16. Shepherd FA, Rodrigues Pereira J, Ciuleanu T, Tan E-H, Hirsh V, Thongprasert S, et al. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med. 2005;353:123–32.

    Article  CAS  PubMed  Google Scholar 

  17. Park K, Tan E-H, O’Byrne K, Zhang L, Boyer M, Mok T, et al. Afatinib versus gefitinib as first-line treatment of patients with EGFR mutation-positive non-small-cell lung cancer (LUX-Lung 7): a phase 2B, open-label, randomised controlled trial. Lancet Oncol. 2016;17:577–89.

    Article  CAS  PubMed  Google Scholar 

  18. Kelly K, Altorki NK, Eberhardt WEE, O’Brien MER, Spigel DR, Crinò L, et al. Adjuvant erlotinib versus placebo in patients with stage IB-IIIA non-small-cell lung cancer (RADIANT): a randomized, double-blind, phase III trial. J Clin Oncol. 2015;33:4007–14.

    Article  CAS  PubMed  Google Scholar 

  19. Schremser K, Rogowski WH, Adler-Reichel S, Tufman ALH, Huber RM, Stollenwerk B. Cost-effectiveness of an individualized first-line treatment strategy offering erlotinib based on EGFR mutation testing in advanced lung adenocarcinoma patients in Germany. Pharmacoeconomics. 2015;33:1215–28.

    Article  PubMed  Google Scholar 

  20. Narita Y, Matsushima Y, Shiroiwa T, Chiba K, Nakanishi Y, Kurokawa T, et al. Cost-effectiveness analysis of EGFR mutation testing and gefitinib as first-line therapy for non-small cell lung cancer. Lung Cancer. 2015;90:71–7.

    Article  PubMed  Google Scholar 

  21. Yang JC-H, Wu Y-L, Schuler M, Sebastian M, Popat S, Yamamoto N, et al. Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials. Lancet Oncol. 2015;16:141–51.

    Article  CAS  PubMed  Google Scholar 

  22. Brown T, Boland A, Bagust A, Oyee J, Hockenhull J, Dundar Y, et al. Gefitinib for the first-line treatment of locally advanced or metastatic non-small cell lung cancer. Health Technol Assess. 2010;14:71–9.

    Article  CAS  PubMed  Google Scholar 

  23. Brown T, Pilkington G, Bagust A, Boland A, Oyee J, Tudur-Smith C, et al. Clinical effectiveness and cost-effectiveness of first-line chemotherapy for adult patients with locally advanced or metastatic non-small cell lung cancer: a systematic review and economic evaluation. Health Technol Assess. 2013;17:1–10.

    Article  Google Scholar 

  24. Vergnenègre A, Massuti B, de Marinis F, Carcereny E, Felip E, Do P, et al. Economic analysis of first-line treatment with erlotinib in an EGFR-mutated population with advanced NSCLC. J Thorac Oncol. 2016;11:801–7.

    Article  PubMed  Google Scholar 

  25. Wang S, Peng L, Li J, Zeng X, Ouyang L, Tan C, et al. A trial-based cost-effectiveness analysis of erlotinib alone versus platinum-based doublet chemotherapy as first-line therapy for Eastern Asian nonsquamous non-small-cell lung cancer. PLoS One. 2013;8:e55917.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Lee VW, Schwander B, Lee VH, et al. Effectiveness and cost-effectiveness of erlotinib versus gefitinib in first-line treatment of epidermal growth factor receptor-activating mutation-positive non-small-cell lung cancer patients in Hong Kong. Hong Kong Med J. 2014;20(3):178–86.

    Article  PubMed  Google Scholar 

  27. Kim ST, Uhm JE, Lee J, Sun J-M, Sohn I, Kim SW, et al. Randomized phase II study of gefitinib versus erlotinib in patients with advanced non-small cell lung cancer who failed previous chemotherapy. Lung Cancer. 2012;75:82–8.

    Article  PubMed  Google Scholar 

  28. Ting J, HoPharmD T, Xiang P, Sugay A, Abdel-Sattar M, Wilson L. Cost-effectiveness and value of information of erlotinib, afatinib, and cisplatin-pemetrexed for first-line treatment of advanced EGFR mutation-positive non-small-cell lung cancer in the United States. Value Health. 2015;18:774–82.

    Article  PubMed  Google Scholar 

  29. Rosell R, Carcereny E, Gervais R, Vergnenegre A, Massuti B, Felip E, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012;13:239–46.

    Article  CAS  PubMed  Google Scholar 

  30. Sequist LV, Yang JC-H, Yamamoto N, O’Byrne K, Hirsh V, Mok T, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol. 2013;31:3327–34.

    Article  CAS  PubMed  Google Scholar 

  31. Horgan AM, Bradbury PA, Amir E, Ng R, Douillard JY, Kim ES, et al. An economic analysis of the INTEREST trial, a randomized trial of docetaxel versus gefitinib as second-/third-line therapy in advanced non-small-cell lung cancer. Ann Oncol. 2011;22:1805–11.

    Article  CAS  PubMed  Google Scholar 

  32. Bradbury PA, Tu D, Seymour L, Isogai PK, Zhu L, Ng R, et al. Economic analysis: randomized placebo-controlled clinical trial of erlotinib in advanced non-small cell lung cancer. J Natl Cancer Inst. 2010;102:298–306.

    Article  CAS  PubMed  Google Scholar 

  33. Nuijten MJC, de Castro Carpeño J, Chouaid C, Vergnenègre A, Grossi F, Bischoff H, et al. A cross-market cost comparison of erlotinib versus pemetrexed for first-line maintenance treatment of patients with locally advanced or metastatic non-small-cell lung cancer. Lung Cancer. 2012;76:465–71.

    Article  PubMed  Google Scholar 

  34. Cappuzzo F, Ciuleanu T, Stelmakh L, Cicenas S, Szczesna A, Juhász E, et al. Erlotinib as maintenance treatment in advanced non-small-cell lung cancer: a multicentre, randomised, placebo-controlled phase 3 study. Lancet Oncol. 2010;11:521–9.

    Article  CAS  PubMed  Google Scholar 

  35. Dickson R, Bagust A, Boland A, Blundell M, Davis H, Dundar Y, et al. Erlotinib monotherapy for the maintenance treatment of non-small cell lung cancer after previous platinum-containing chemotherapy. Pharmacoeconomics. 2011;29:1051–62.

    Article  PubMed  Google Scholar 

  36. Klein R, Wielage R, Muehlenbein C, Liepa AM, Babineaux S, Lawson A, et al. Cost-effectiveness of pemetrexed as first-line maintenance therapy for advanced nonsquamous non-small cell lung cancer. J Thorac Oncol. 2010;5:1263–72.

    Article  PubMed  Google Scholar 

  37. Khan I, Morris S, Hackshaw A, Lee S-M. Cost-effectiveness of first-line erlotinib in patients with advanced non-small-cell lung cancer unsuitable for chemotherapy. BMJ Open. 2015;5:e006733.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Carlson JJ, Reyes C, Oestreicher N, Lubeck D, Ramsey SD, Veenstra DL. Comparative clinical and economic outcomes of treatments for refractory non-small cell lung cancer (NSCLC). Lung Cancer. 2008;61:405–15.

    Article  PubMed  Google Scholar 

  39. Cromwell I, van der Hoek K, Taylor SCM, Melosky B, Peacock S. Erlotinib or best supportive care for third-line treatment of advanced non-small-cell lung cancer: a real-world cost-effectiveness analysis. Lung Cancer. 2012;76:472–7.

    Article  PubMed  Google Scholar 

  40. Mok TS, Wu Y-L, Ahn M-J, Garassino MC, Kim HR, Ramalingam SS, et al. Osimertinib or platinum-pemetrexed in EGFRT790M-positive lung cancer. N Engl J Med. 2017;376:629–40.

    Article  CAS  PubMed  Google Scholar 

  41. Atherly AJ, Camidge DR. The cost-effectiveness of screening lung cancer patients for targeted drug sensitivity markers. Br J Cancer. 2012;106:1100–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Djalalov S, Beca J, Hoch JS, Krahn M, Tsao MS, Cutz JC, et al. Cost effectiveness of EML4-ALK fusion testing and first-line crizotinib treatment for patients with advanced ALK-positive non-small-cell lung cancer. J Clin Oncol. 2014;32:1012–9.

    Article  PubMed  Google Scholar 

  43. Hurry M, Zhou Z-Y, Zhang J, Zhang C, Fan L, Rebeira M, et al. Cost-effectiveness of ceritinib in patients previously treated with crizotinib in anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer in Canada. J Med Econ. 2016;19:936–44.

    Article  PubMed  Google Scholar 

  44. Shaw AT, Kim D-W, Mehra R, Tan DSW, Felip E, Chow LQM, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014;370:1189–97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Crinò L, Ahn M-J, de Marinis F, Groen HJM, Wakelee H, Hida T, et al. Multicenter phase II study of whole-body and intracranial activity with ceritinib in patients with ALK-rearranged non-small-cell lung cancer previously treated with chemotherapy and crizotinib: results from ASCEND-2. J Clin Oncol. 2016;34:2866–73.

    Article  PubMed  Google Scholar 

  46. Final recommendation: ceritinib (resubmission). 2017. http://www.cadth.ca/sites/default/files/pcodr/pcodr_ceritinib_zykadia_nsclc_resub_fn_rec.pdf. Accessed 6 Aug 2017.

  47. Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim D-W, et al. Alectinib versus crizotinib in untreated ALK-positive non-small-cell lung cancer. N Engl J Med. 2017. doi:10.1056/NEJMoa1704795.

    Google Scholar 

  48. Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, et al. Paclitaxel–carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006;355:2542–50.

    Article  CAS  PubMed  Google Scholar 

  49. Reck M, von Pawel J, Zatloukal P, Ramlau R, Gorbounova V, Hirsh V, et al. Phase III trial of cisplatin plus gemcitabine with either placebo or bevacizumab as first-line therapy for nonsquamous non-small-cell lung cancer: AVAil. J Clin Oncol. 2009;27:1227–34.

    Article  CAS  PubMed  Google Scholar 

  50. Giuliani G, Grossi F, de Marinis F, Walzer S. Cost-effectiveness analysis of bevacizumab versus pemetrexed for advanced non-squamous NSCLC in Italy. Lung Cancer. 2010;69(Suppl. 1):S11–7.

    Article  PubMed  Google Scholar 

  51. Ahn M-J, Tsai C-M, Hsia T-C, Wright E, Chang JW-C, Kim HT, et al. Cost-effectiveness of bevacizumab-based therapy versus cisplatin plus pemetrexed for the first-line treatment of advanced non-squamous NSCLC in Korea and Taiwan. Asia Pac J Clin Oncol. 2011;7(Suppl. 2):22–33.

    Article  PubMed  Google Scholar 

  52. Klein R, Muehlenbein C, Liepa AM, Babineaux S, Wielage R, Schwartzberg L. Cost-effectiveness of pemetrexed plus cisplatin as first-line therapy for advanced nonsquamous non-small cell lung cancer. J Thorac Oncol. 2009;4:1404–14.

    Article  PubMed  Google Scholar 

  53. Goulart B, Ramsey S. A trial-based assessment of the cost-utility of bevacizumab and chemotherapy versus chemotherapy alone for advanced non-small cell lung cancer. Value Health. 2011;14:836–45.

    Article  PubMed  Google Scholar 

  54. Garon EB, Ciuleanu T-E, Arrieta O, Prabhash K, Syrigos KN, Goksel T, et al. Ramucirumab plus docetaxel versus placebo plus docetaxel for second-line treatment of stage IV non-small-cell lung cancer after disease progression on platinum-based therapy (REVEL): a multicentre, double-blind, randomised phase 3 trial. Lancet. 2014;384:665–73.

    Article  CAS  PubMed  Google Scholar 

  55. Reck M, Kaiser R, Mellemgaard A, Douillard J-Y, Orlov S, Krzakowski M, et al. Docetaxel plus nintedanib versus docetaxel plus placebo in patients with previously treated non-small-cell lung cancer (LUME-Lung 1): a phase 3, double-blind, randomised controlled trial. Lancet Oncol. 2014;15:143–55.

    Article  CAS  PubMed  Google Scholar 

  56. Espinosa Bosch M, Asensi Diez R, García Agudo S, Clopes Estela A. Nintedanib in combination with docetaxel for second-line treatment of advanced non-small-cell lung cancer; GENESIS-SEFH drug evaluation report. Farm Hosp. 2016;40:316–27.

    PubMed  Google Scholar 

  57. Joerger M, Matter-Walstra K, Fruh M, Kuhnel U, Szucs T, Pestalozzi B, et al. Addition of cetuximab to first-line chemotherapy in patients with advanced non-small-cell lung cancer: a cost-utility analysis. Ann Oncol. 2011;22:567–74.

    Article  CAS  PubMed  Google Scholar 

  58. Goldstein DA, Chen Q, Ayer T, Howard DH, Lipscomb J, Ramalingam SS, et al. Necitumumab in metastatic squamous cell lung cancer. JAMA Oncol. 2015;1:1293–8.

    Article  PubMed  Google Scholar 

  59. Umeweni N, Knight H, McVeigh G. NICE guidance on necitumumab for untreated advanced or metastatic squamous non-small-cell lung cancer. Lancet Oncol. 2016;17:1483–4.

    Article  PubMed  Google Scholar 

  60. Reck M, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, et al. Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer. N Engl J Med. 2016;375:1823–33.

    Article  CAS  PubMed  Google Scholar 

  61. Goeree R, Villeneuve J, Goeree J, Penrod JR, Orsini L, Tahami Monfared AA. Economic evaluation of nivolumab for the treatment of second-line advanced squamous NSCLC in Canada: a comparison of modeling approaches to estimate and extrapolate survival outcomes. J Med Econ. 2016;19:1–16.

    Article  Google Scholar 

  62. Matter-Walstra K, Schwenkglenks M, Aebi S, Dedes K, Diebold J, Pietrini M, et al. A cost-effectiveness analysis of nivolumab versus docetaxel for advanced nonsquamous NSCLC including PD-L1 testing. J Thorac Oncol. 2016;11(11):1846–55.

    Article  PubMed  Google Scholar 

  63. Huang M, Lou Y, Pellissier J, Burke T, Liu FX, Xu R, et al. Cost-effectiveness of pembrolizumab versus docetaxel for the treatment of previously treated PD-L1 positive advanced NSCLC patients in the United States. J Med Econ. 2017;20(2):140–50.

    Article  PubMed  Google Scholar 

  64. Romanus D, Cardarella S, Cutler D, Landrum MB, Lindeman NI, Gazelle GS. Cost-effectiveness of multiplexed predictive biomarker screening in non-small-cell lung cancer. J Thorac Oncol. 2015;10:586–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Doble B, John T, Thomas D, Fellowes A, Fox S, Lorgelly P. Cost-effectiveness of precision medicine in the fourth-line treatment of metastatic lung adenocarcinoma: an early decision analytic model of multiplex targeted sequencing. Lung Cancer. 2017;107:22–35.

    Article  PubMed  Google Scholar 

  66. Reaume MN, Leighl NB, Mittmann N, Coyle D, Hirsh V, Seymour L, et al. Economic analysis of a randomized phase III trial of gemcitabine plus vinorelbine compared with cisplatin plus vinorelbine or cisplatin plus gemcitabine for advanced non-small-cell lung cancer (Italian GEMVIN3/NCIC CTG BR14 trial). Lung Cancer. 2013;82:115–20.

    Article  PubMed  Google Scholar 

  67. Ramsey SD, Bansal A, Fedorenko CR, Blough DK, Overstreet KA, Shankaran V, et al. Financial insolvency as a risk factor for early mortality among patients with cancer. J Clin Oncol. 2016;34:980–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Chouaid C, Le Caer H, Locher C, Dujon C, Thomas P, Auliac JB, et al. Cost effectiveness of erlotinib versus chemotherapy for first-line treatment of non small cell lung cancer (NSCLC) in fit elderly patients participating in a prospective phase 2 study (GFPC 0504). BMC Cancer. 2012;12:301.

    Article  PubMed  Google Scholar 

  69. Chouaid C, Le Caer H, Corre R, Crequit J, Locher C, Falchero L, et al. Cost analysis of erlotinib versus chemotherapy for first-line treatment of non-small-cell lung cancer in frail elderly patients participating in a prospective phase 2 study (GFPC 0505). Clin Lung Cancer. 2013;14:103–7.

    Article  PubMed  Google Scholar 

  70. Graham J, Earnshaw S, Lim J, Luthra R, Borker R. Cost-effectiveness of afatinib versus erlotinib in the first-line treatment of patients with metastatic non-small cell lung cancer with EGFR exon 19 deletion mutations. 2016. p. 31–9. http://www.journalofclinicalpathways.com/article/cost-effectiveness-afatinib-versus-erlotinib-first-line-treatment-patients-metastatic-non. Accessed 12 Aug 2017.

  71. Thongprasert S, Tinmanee S, Persuwan U. Cost-utility and budget impact analyses of gefitinib in second-line treatment for advanced non-small cell lung cancer from Thai payer perspective. Asia Pac J Clin Oncol. 2012;8:53–61.

    Article  PubMed  Google Scholar 

  72. Lewis G, Peake M, Aultman R, Gyldmark M, Morlotti L, Creeden J, et al. Cost-effectiveness of erlotinib versus docetaxel for second-line treatment of advanced non-small-cell lung cancer in the United Kingdom. J Int Med Res. 2010;38:9–21.

    Article  CAS  PubMed  Google Scholar 

  73. Cromwell I, van der Hoek K, Melosky B, Peacock S. Erlotinib or docetaxel for second-line treatment of non-small cell lung cancer: a real-world cost-effectiveness analysis. J Thorac Oncol. 2011;6:2097–103.

    Article  PubMed  Google Scholar 

  74. Zhu J, Te Li, Wang X, Ye M, Cai J, Xu Y, et al. Gene-guided gefitinib switch maintenance therapy for patients with advanced EGFR mutation-positive non-small cell lung cancer: an economic analysis. BMC Cancer. 2013;13:39.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Zeng X, Li J, Peng L, Wang Y, Tan C, Chen G, et al. Economic outcomes of maintenance gefitinib for locally advanced/metastatic non-small-cell lung cancer with unknown EGFR mutations: a semi-Markov model analysis. PLoS One. 2014;9:e88881.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Vergnenègre A, Ray JA, Chouaid C, Grossi F, Bischoff HG, Heigener DF, Walzer S, et al. Cross-market cost-effectiveness analysis of erlotinib as first-line maintenance treatment for patients with stable non-small cell lung cancer. Clinicoecon Outcomes Res. 2012;4:31–7.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Walleser S, Ray J, Bischoff H, Vergnenègre A, Rosery H, Chouaid C, et al. Maintenance erlotinib in advanced nonsmall cell lung cancer: cost-effectiveness in EGFR wild-type across Europe. Clinicoecon Outcomes Res. 2012;4:269–75.

    PubMed  PubMed Central  Google Scholar 

  78. Borget I, Pérol M, Pérol D, Lavolé A, Greillier L, Do P, et al. Cost-utility analysis of maintenance therapy with gemcitabine or erlotinib vs observation with predefined second-line treatment after cisplatin–gemcitabine induction chemotherapy for advanced NSCLC: IFCT-GFPC 0502-Eco phase III study. BMC Cancer. 2014;14:953.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Araújo A, Parente B, Sotto-Mayor R, Teixeira E, Almodôvar T, Barata F, et al. An economic analysis of erlotinib, docetaxel, pemetrexed and best supportive care as second or third line treatment of non-small cell lung cancer. Rev Port Pneumol. 2008;14:803–27.

    Article  PubMed  Google Scholar 

  80. Hess LM, Rajan N, Winfree K, Davey P, Ball M, Knox H, et al. Cost analyses in the US and Japan: a cross-country comparative analysis applied to the PRONOUNCE Trial in non-squamous non-small cell lung cancer. Adv Ther. 2015;32:1248–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Gilden DM, Kubisiak JM, Pohl GM, Ball DE, Gilden DE, John WJ, et al. Treatment patterns and cost-effectiveness of first line treatment of advanced non-squamous non-small cell lung cancer in Medicare patients. J Med Econ. 2017;20:151–61

    Article  PubMed  Google Scholar 

  82. Fukuoka M, Yano S, Giaccone G, Tamura T, Nakagawa K, Douillard J-Y, et al. Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer (The IDEAL 1 Trial) [corrected]. J Clin Oncol. 2003;21:2237–46.

    Article  CAS  PubMed  Google Scholar 

  83. Wu Y-L, Zhou C, Hu C-P, Feng J, Lu S, Huang Y, et al. Afatinib versus cisplatin plus gemcitabine for first-line treatment of Asian patients with advanced non-small-cell lung cancer harbouring EGFR mutations (LUX-Lung 6): an open-label, randomised phase 3 trial. Lancet Oncol. 2014;15:213–22.

    Article  CAS  PubMed  Google Scholar 

  84. Pirker R, Pereira JR, Szczesna A, von Pawel J, Krzakowski M, Ramlau R, et al. Cetuximab plus chemotherapy in patients with advanced non-small-cell lung cancer (FLEX): an open-label randomised phase III trial. Lancet. 2009;373:1525–31.

    Article  CAS  PubMed  Google Scholar 

  85. Shaw AT, Kim D-W, Nakagawa K, Seto T, Crinò L, Ahn M-J, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013;368:2385–94.

    Article  CAS  PubMed  Google Scholar 

  86. Solomon BJ, Mok T, Kim D-W, Wu Y-L, Nakagawa K, Mekhail T, et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer. N Engl J Med. 2014;371:2167–77.

    Article  PubMed  Google Scholar 

  87. Soria J-C, Tan DSW, Chiari R, Wu Y-L, Paz-Ares L, Wolf J, et al. First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): a randomised, open-label, phase 3 study. Lancet. 2017;389:917–29.

    Article  CAS  PubMed  Google Scholar 

  88. Shaw AT, Gandhi L, Gadgeel S, Riely GJ, Cetnar J, West H, et al. Alectinib in ALK-positive, crizotinib-resistant, non-small-cell lung cancer: a single-group, multicentre, phase 2 trial. Lancet Oncol. 2016;17:234–42.

    Article  CAS  PubMed  Google Scholar 

  89. Kim D-W, Tiseo M, Ahn M-J, Reckamp KL, Hansen KH, Kim S-W, et al. Brigatinib in patients with crizotinib-refractory anaplastic lymphoma kinase-positive non-small-cell lung cancer: a randomized, multicenter phase II trial. J Clin Oncol. 2017;35:2490–8.

    Article  PubMed  Google Scholar 

  90. Herbst RS, Baas P, Kim D-W, Felip E, Pérez-Gracia JL, Han J-Y, et al. Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet. 2016;387:1540–50.

    Article  CAS  PubMed  Google Scholar 

  91. Rittmeyer A, Barlesi F, Waterkamp D, Park K, Ciardiello F, von Pawel J, et al. Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial. Lancet. 2017;389:255–65.

    Article  PubMed  Google Scholar 

  92. Fehrenbacher L, Spira A, Ballinger M, Kowanetz M, Vansteenkiste J, Mazières J, et al. Atezolizumab versus docetaxel for patients with previously treated non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2 randomised controlled trial. Lancet. 2016;387:1837–46.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Hamzeh Albaba and Charles Lim contributed equally to this article and are co-first authors.

Authors and Affiliations

  1. Princess Margaret Cancer Center, University Health Network, c/o 700 University Avenue, Room 7-913, Toronto, ON, M5G 1Z5, Canada

    Hamzeh Albaba, Charles Lim & Natasha B. Leighl

  2. University of Toronto, Toronto, ON, Canada

    Hamzeh Albaba, Charles Lim & Natasha B. Leighl

Authors
  1. Hamzeh Albaba
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charles Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Natasha B. Leighl
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors were involved in the manuscript design, literature review, manuscript writing, review and final approval.

Corresponding author

Correspondence to Natasha B. Leighl.

Ethics declarations

Funding

No funding was received for the preparation of this article.

Conflict of interest

Hamzeh Albaba and Charles Lim declare no known conflicts of interest. Natasha B. Leighl reports institutional research funding (University Health Network) for an unrelated clinical trial from Novartis, consulting fees from the Canadian Agency for Drugs and Technologies in Health, and honoraria for continuing medical education lectures from Astra Zeneca, Bristol Myers Squibb, Merck Sharp & Dohme and Pfizer.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 53 kb)

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Albaba, H., Lim, C. & Leighl, N.B. Economic Considerations in the Use of Novel Targeted Therapies for Lung Cancer: Review of Current Literature. PharmacoEconomics 35, 1195–1209 (2017). https://doi.org/10.1007/s40273-017-0563-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40273-017-0563-8

search

Navigation