Costs of adverse events associated with afatinib, erlotinib, and gefitinib first-line therapies in advanced non-small-cell lung cancer harboring EGFR-activating mutations

Il Costo Degli Eventi Avversi Associati ad Afatinib, Erlotinib e Gefitinib Nel Trattamento del Tumore del Polmone non a Piccole Cellule con Mutazione EGFR

Abstract

Introduction Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) afatinib, erlotinib, and gefitinib are an established treatment for advanced non-small cell lung cancer (NSCLC) with EGFR mutation. Objectives Consistent with published meta-analyses, this study compares the cost of management of the adverse events (AEs) associated with these three drugs from the perspective of the Italian National Health System (NHS). Methods The frequency of AEs was established based on a recently published meta-analysis. Only the costs of management of the AEs were considered. Resource utilization in the management of the AEs was estimated by a panel of Italian oncologists and based on previously published studies. Results The mean cost per patient treated with afatinib, erlotinib, and gefitinib was €141.03, €90.74 and 121.87, respectively. With afatinib, the cost per patient and per AE of grades ≤2 and ≥3 was €36.70 and €104.33. With erlotinib, the cost per patient and per AE of grades ≤2 and ≥3 was €46.99 and €40.75, whereas the cost with gefitinib was €34.76 and €87.11, respectively. Conclusion In advanced EGFR mutation-positive NSCLC patients, first-line treatment with erlotinib could reduce the cost of management of the AEs for the NHS.