TY - JOUR AU - Ravasio, Roberto AU - Cranmer, Holly AU - Kearns , Izzie AU - Viti, Raffaella AU - Corinti, Simone PY - 2022/10/24 Y2 - 2024/03/29 TI - Cost-utility analysis of brigatinib compared to alectinib in the treatment of ALK-positive NSCLC in patients previously not treated with an ALK inhibitor JF - AboutOpen JA - AboutOpen VL - 9 IS - 1 SE - Original research articles DO - 10.33393/ao.2022.2450 UR - https://journals.aboutscience.eu/index.php/aboutopen/article/view/2450 SP - 92-104 AB - <p class="abstract"><strong>Objective:</strong> 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).</p><p class="abstract"><strong>Methods:</strong> 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).</p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p> ER -