Cost-utility analysis of brigatinib compared to alectinib in the treatment of ALK-positive NSCLC in patients previously not treated with an ALK inhibitor
DOI:
https://doi.org/10.33393/ao.2022.2450Keywords:
Alectinib, ALK-positive, Brigatinib, Cost-utility, Italian NHS, NSCLCAbstract
Objective: The aim of this economic evaluation was to assess the cost-utility of brigatinib versus alectinib in the treatment of naïve patients to anaplastic lymphoma kinase-positive advanced non-small cell lung cancer (ALK-positive aNSCLC) from the perspective of the Italian National Health Service (INHS).
Methods: A partitioned survival model with four health states (progression-free [PFS], no central nervous system progression [CNS-PFS], central nervous system progression [CNS-PD] and death) was used. The clinical data (progression-free survival, overall survival and time to progression) was based on the ALTA-1L trial for brigatinib and on ALEX trial for alectinib. Utility values were derived from EORTC QLQ-C30 scores evaluated in the ALTA-1L trial and literature. Costs included frontline therapies, subsequent therapies, best supportive care (BSC), administration, concomitant medications, adverse events and health states. Direct medical costs and benefits (quality-adjusted life-years, QALYs) were discounted at a 3.0% annual rate. Uncertainty was assessed using deterministic (DSA) and probabilistic sensitivity analyses (PSA).
Results: The analysis showed that brigatinib was dominant versus alectinib; brigatinib led to a gain of 0.216 QALYs and to a treatment cost reduction of € 85,635. The results of the DSA showed that no parameters of the model significantly modified the base case result.
Conclusions: This economic evaluation suggested that, compared with alectinib, brigatinib can be considered a valid cost-utility option from the perspective of INHS in the treatment of patients with ALK-positive aNSCLC.
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Copyright (c) 2022 Roberto Ravasio, Holly Cranmer, Izzie Kearns , Raffaella Viti, Simone Corinti
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2022-09-27
Published 2022-10-24
