Department of Pharmacy, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu Province, PR China.
Department of Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province, PR China.
Future Oncol. 2019 Jan;15(2):181-191. doi: 10.2217/fon-2018-0692. Epub 2018 Oct 15.
To evaluate the cost-utility of gefitinib and afatinib as first-line EGFR-mutated non-small-cell lung cancer treatments from the Chinese healthcare system perspective.
MATERIALS & METHODS: A Markov model was established, state transition probabilities were extracted from the LUX-Lung7 trial and utility values were from previous studies. The cost was extracted from local charge or relevant literature. Incremental cost-effectiveness ratio was calculated for intention-to-treat, EGFR exon 19 deletion (del19) and exon Leu858Arg (21L858R, L858R) muation subgroups. Results: For the entire population, the afatinib regimen afforded additional 0.29 quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios were US$9820.41/QALY, US$18,529.65/QALY and US$1585.51/QALY for intention-to-treat, L858R and del19, respectively.
First-line afatinib was more cost-effective than gefitinib for EFGR-mutated advanced non-small-cell lung cancer in China.
从中国医疗体系的角度评估吉非替尼和阿法替尼作为一线治疗表皮生长因子受体（EGFR）突变型非小细胞肺癌的成本-效用。
建立了一个马尔可夫模型，从 LUX-Lung7 试验中提取状态转移概率，从先前的研究中提取效用值。成本从当地收费或相关文献中提取。针对意向治疗、EGFR 外显子 19 缺失（del19）和外显子 Leu858Arg（21L858R，L858R）突变亚组计算增量成本-效果比。结果：对于整个人群，阿法替尼方案提供了额外的 0.29 个质量调整生命年（QALY）。意向治疗、L858R 和 del19 亚组的增量成本-效果比分别为 9820.41 美元/QALY、18529.65 美元/QALY 和 1585.51 美元/QALY。
对于中国的 EGFR 突变型晚期非小细胞肺癌，一线阿法替尼比吉非替尼更具成本效益。
