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

OBJECTIVES: Lung cancer remains the commonest cause of death from cancer worldwide, posing a high disease and economic burden on healthcare systems globally. Alectinib is a highly selective, CNS-active anaplastic lymphoma kinase (ALK) inhibitor. 5% of non-small cell lung cancer (NSCLC) patients carr...

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Bibliographic Details
Published in:Value in health 2017-10, Vol.20 (9), p.A433
Main Authors: Kourkoulas, N, Kyriopoulos, D, Athanasakis, K
Format: Article
Language:English
Subjects:
Analysis
Cancer therapies
Central nervous system
Chemotherapy
Clinical effectiveness
Cost analysis
Discounts
Enzyme inhibitors
Health care expenditures
Health care industry
Health insurance
Life expectancy
Life span
Lung cancer
Lymphoma
Metastases
Metastasis
Non-small cell lung carcinoma
Oncologists
Patients
Protein-tyrosine kinase
Quality adjusted life years
Social security
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Summary:OBJECTIVES: Lung cancer remains the commonest cause of death from cancer worldwide, posing a high disease and economic burden on healthcare systems globally. Alectinib is a highly selective, CNS-active anaplastic lymphoma kinase (ALK) inhibitor. 5% of non-small cell lung cancer (NSCLC) patients carry mutations associated with ALK (ALK positive). The objective of this analysis was to perform a cost-effectiveness analysis of Alectinib compared to chemotherapy for the treatment of treatment-naive patients with ALK positive locally advanced or metastatic NSCLC in Greece. METHODS: A health economic model was developed using an "area under the curve" partitioned survival (three mutually exclusive health states) semi-Markov type analysis. The model was populated with clinical effectiveness data from the literature and Greek-specific data on health resource use and costs collected from an expert panel of 10 oncologists. This analysis did not account for discounts/rebates. The analysis followed a third party payer perspective (Greek Social Insurance). RESULTS: Alectinib compared to chemotherapy was accompanied by gains of 2,1 total life years (LY) (5,01 vs 2,91) and a gain in Quality Adjusted Life Expectancy of 1,76 QALYs (3,74 vs 1,98 QALY's gained). Alectinib is associated with an additional cost of €151.550 (€201.554 vs €50.004) compared to chemotherapy per patient, resulting in an incremental cost effectiveness ratio (ICER) of 72.348 per LY gained and 85.965 per QALY gained. The results are sensitive to the price of the intervention. CONCLUSIONS: The population of ALK positive NSCLC patients in Greece is estimated to be approximately 120 patients per year in Greece. Alectinib contributes towards significant health gains in LY and QALYs compared to chemotherapy at a reasonable cost.
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2017.08.200