#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Cost-effectiveness of alectinib compared to crizotinib for the treatment of first-line ALK+ advanced non-small-cell lung cancer in France


Autoři: Marine Sivignon aff001;  Rémi Monnier aff001;  Bertrand Tehard aff002;  Stéphane Roze aff001
Působiště autorů: Heva Heor, Lyon, France aff001;  Roche, Boulogne-Billancourt, France aff002
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226196

Souhrn

The aim of the study is to evaluate the cost-effectiveness of alectinib for first-line treatment of ALK+ advanced non-small-cell lung cancer compared to crizotinib in the French setting. This study used a partitioned survival model, with three discrete health states (progression-free survival, post-progression survival and death). Survival probabilities were derived from a randomised Phase III clinical trial comparing alectinib to crizotinib (ALEX). Beyond the length of the trial (18 months), the efficacy of both treatments was considered equivalent. Occurrence of adverse events or brain metastases were considered as inter-current events. Utilities (and disutilities for intercurrent adverse events) derived from the EQ-5D were applied. Costs were attributed using standard French national public health tariffs. Projected mean overall survival was 4.62 years for alectinib and 4.18 years for crizotinib. Projected mean progression-free survival was 30.30 months for alectinib and 16.13 months for crizotinib. The total number of quality-adjusted life years projected was 3.40 for alectinib and 2.84 for crizotinib. The projected total cost of treatment over the lifetime of the model was € 246,022 for alectinib and € 195,486 for crizotinib. This extra cost was principally attributable to treatment acquisition costs and management before progression. Alectinib was associated with lower costs related to brain metastases and to management post-progression. The incremental cost per life year gained was 115,334 €/year and the incremental cost-effectiveness ratio was 90,232 €/QALY. First-line treatment of ALK+ NSCLC with alectinib provides superior clinical outcomes to crizotinib and is cost-effective in the French context.

Klíčová slova:

Adverse events – Brain metastasis – Cancer treatment – Cost-effectiveness analysis – Extrapolation – France – Lung and intrathoracic tumors – Non-small cell lung cancer


Zdroje

1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 2013;49:1374–1403. doi: 10.1016/j.ejca.2012.12.027 23485231

2. Institut national du cancer. Les cancers en France, édition 2016. Institut national du cancer, 2017.

3. Hirsch FR, Scagliotti GV, Mulshine JL, Kwon R, Curran WJ Jr., Wu YL, et al. Lung cancer: current therapies and new targeted treatments. Lancet 2017;389:299–311. doi: 10.1016/S0140-6736(16)30958-8 27574741

4. Institut National du Cancer. Les thérapies ciblées dans le traitement du cancer en 2015 /États des lieux et enjeux, appui à la décision Paris: INCa, 2016.

5. Novello S, Barlesi F, Califano R, Cufer T, Ekman S, Levra MG, et al. Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016;27:v1–v27. doi: 10.1093/annonc/mdw326 27664245

6. Couraud S, Toffart A-C, Souquet P-J, Comité de rédaction des référentiels Auvergne Rhône-Alpes en oncologie thoracique. Cancer bronchique non à petites cellules: actualisation 2018. ARISTOT, 2018.

7. Rothenstein JM, Chooback N. ALK inhibitors, resistance development, clinical trials. Curr Oncol 2018;25:S59–s67. doi: 10.3747/co.25.3760 29910648

8. Rossi A. Alectinib for ALK-positive non-small-cell lung cancer. Expert Rev Clin Pharmacol 2016;9:1005–1013. doi: 10.1080/17512433.2016.1195262 27232673

9. Kodama T, Hasegawa M, Takanashi K, Sakurai Y, Kondoh O, Sakamoto H. Antitumor activity of the selective ALK inhibitor alectinib in models of intracranial metastases. Cancer Chemother Pharmacol 2014;74:1023–1028. doi: 10.1007/s00280-014-2578-6 25205428

10. Riihimaki M, Hemminki A, Fallah M, Thomsen H, Sundquist K, Sundquist J, et al. Metastatic sites and survival in lung cancer. Lung Cancer 2014;86:78–84. doi: 10.1016/j.lungcan.2014.07.020 25130083

11. Peters S, Bexelius C, Munk V, Leighl N. The impact of brain metastasis on quality of life, resource utilization and survival in patients with non-small-cell lung cancer. Cancer Treat Rev 2016;45:139–162. doi: 10.1016/j.ctrv.2016.03.009 27019457

12. Dempke WC, Edvardsen K, Lu S, Reinmuth N, Reck M, Inoue A. Brain Metastases in NSCLC—are TKIs Changing the Treatment Strategy? Anticancer Res 2015;35:5797–5806. 26504000

13. Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim DW, et al. Alectinib versus Crizotinib in Untreated ALK-Positive Non-Small-Cell Lung Cancer. N Engl J Med 2017;377:829–838. doi: 10.1056/NEJMoa1704795 28586279

14. Hida T, Nokihara H, Kondo M, Kim YH, Azuma K, Seto T, et al. Alectinib versus crizotinib in patients with ALK-positive non-small-cell lung cancer (J-ALEX): an open-label, randomised phase 3 trial. Lancet 2017;390:29–39. doi: 10.1016/S0140-6736(17)30565-2 28501140

15. Barlesi F, Mazieres J, Merlio JP, Debieuvre D, Mosser J, Lena H, et al. Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup (IFCT). Lancet 2016;387:1415–1426. doi: 10.1016/S0140-6736(16)00004-0 26777916

16. Novello S, Mazieres J, Oh IJ, de Castro J, Migliorino MR, Helland A, et al. Alectinib versus chemotherapy in crizotinib-pretreated anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer: results from the phase III ALUR study. Ann Oncol 2018;29:1409–1416. doi: 10.1093/annonc/mdy121 29668860

17. Shaw AT, Kim TM, Crino L, Gridelli C, Kiura K, Liu G, et al. Ceritinib versus chemotherapy in patients with ALK-rearranged non-small-cell lung cancer previously given chemotherapy and crizotinib (ASCEND-5): a randomised, controlled, open-label, phase 3 trial. Lancet Oncol 2017;18:874–886. doi: 10.1016/S1470-2045(17)30339-X 28602779

18. Latimer NR. NICE Decision Support Unit Technical Support Documents. Survival Analysis For Economic Evaluations Alongside Clinical Trials—Extrapolation with Patient-Level Data. London: National Institute for Health and Care Excellence (NICE); 2013.

19. Solomon BJ, Kim DW, Wu YL, Nakagawa K, Mekhail T, Felip E, et al. Final Overall Survival Analysis From a Study Comparing First-Line Crizotinib Versus Chemotherapy in ALK-Mutation-Positive Non-Small-Cell Lung Cancer. J Clin Oncol 2018:Jco2017774794.

20. Guerin A, Sasane M, Zhang J, Culver KW, Dea K, Nitulescu R, et al. Brain metastases in patients with ALK+ non-small cell lung cancer: clinical symptoms, treatment patterns and economic burden. J Med Econ 2015;18:312–322. doi: 10.3111/13696998.2014.1003644 25565443

21. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 1990;16:199–208. doi: 10.1016/0168-8510(90)90421-9 10109801

22. Chevalier J, de Pouvourville G. Valuing EQ-5D using time trade-off in France. Eur J Health Econ 2013;14:57–66. doi: 10.1007/s10198-011-0351-x 21935715

23. Chevalier J, Lay KL, Pouvourville G. Health state utility values in advanced non-small cell lung cancer patients. Value Health 2013;16:A419.

24. Nafees B, Stafford M, Gavriel S, Bhalla S, Watkins J. Health state utilities for non small cell lung cancer. Health Qual Life Outcomes 2008;6:84. doi: 10.1186/1477-7525-6-84 18939982

25. Westwood M, Joore M, Whiting P, van Asselt T, Ramaekers B, Armstrong N, et al. Epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutation testing in adults with locally advanced or metastatic non-small cell lung cancer: a systematic review and cost-effectiveness analysis. Health Technol Assess 2014;18:1–166.

26. Girard N, Cozzone D, De Leotoing L, Tournier C, Vainchtock A, Tehard B, et al. Extra-cost of brain metastases (BM) in patients with non-squamous non-small cell lung cancer (NSCLC): a French national hospital database analysis. ESMO J.

27. Banz K, Bischoff H, Brunner M, Chouaid C, de Castro Carpeno J, de Marinis F, et al. Comparison of treatment costs of grade 3/4 adverse events associated with erlotinib or pemetrexed maintenance therapy for patients with advanced non-small-cell lung cancer (NSCLC) in Germany, France, Italy, and Spain. Lung Cancer 2011;74:529–534. doi: 10.1016/j.lungcan.2011.04.010 21592611

28. Wehler E, Zhao Z, Pinar Bilir S, Munakata J, Barber B. Economic burden of toxicities associated with treating metastatic melanoma in eight countries. Eur J Health Econ 2017;18:49–58. doi: 10.1007/s10198-015-0757-y 26721505

29. Agence technique de l'information sur l'hospitalisation. Référentiels de coûts ENC MCO. Lyon: ATIH, 2015.

30. Haute Autorité de la Santé. Choix méthodologiques pour l’évaluation économique à la HAS: guide méthodologique. Paris: HAS, 2011.

31. Burudpakdee C, Wong W, Seetasitha A, Corvino FA, Yeh W, Gubens M. Economic impact of preventing brain metastases with alectinib in ALK-positive non-small cell lung cancer. Lung Cancer 2018;119:103–111. doi: 10.1016/j.lungcan.2018.03.008 29656744

32. Kourkoulas N,., Kyriopoulos D, Athanasakis K. Cost-effectiveness analysis of alectinib compared to chemotherapy for the treatment of treatment-naïve patients with ALK-positive locally advanced or metastatic non-small cell lung cancer (NSCLC) in Greece. Value Health 2017;20:A433.

33. National Institute of Health and Care Ecellence. Alectinib for untreated ALKAlectinib for untreated ALK-positive advanced non-small-cell lung cancer. London: NICE, 2018.

34. Haute Autorité de Santé. Avis d'efficience. Opido (nivulumab). Cancer bronchique non à petites cellules. Non-épidermoïde (2ème ligne). Paris: HAS, 2016.

35. Haute Autorité de la Santé. Avis d'efficience. Opdivo® (nivolumab). Cancer bronchique non à petites cellules Epidermoïde (2ème ligne). 2015.

36. Haute Autorité de la Santé. Commission de la Transparence. Avis 30 mai 2018: Alecensa 150 mg gélules. 2018.


Článek vyšel v časopise

PLOS One


2020 Číslo 1
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

Svět praktické medicíny 1/2024 (znalostní test z časopisu)
nový kurz

Koncepce osteologické péče pro gynekology a praktické lékaře
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Význam metforminu pro „udržitelnou“ terapii diabetu
Autoři: prof. MUDr. Milan Kvapil, CSc., MBA

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#