Use of [177Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study
Aim: To evaluate the cost-effectiveness of [177Lu]Lu-DOTA-TATE versus relevant comparators for the treatment of neuroendocrine tumours located in the gastrointestinal tract (GI-NETs) and the pancreas (P-NETs). Materials and methods: A three-state partitioned survival model was developed to perform a...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-11-01
|
| Series: | EJC Supplements |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1359634921000033 |
| _version_ | 1818935657123282944 |
|---|---|
| author | Matthew Glover Martyn Caplin Oscar R. Leeuwenkamp Louise Longworth |
| author_facet | Matthew Glover Martyn Caplin Oscar R. Leeuwenkamp Louise Longworth |
| author_sort | Matthew Glover |
| collection | DOAJ |
| description | Aim: To evaluate the cost-effectiveness of [177Lu]Lu-DOTA-TATE versus relevant comparators for the treatment of neuroendocrine tumours located in the gastrointestinal tract (GI-NETs) and the pancreas (P-NETs). Materials and methods: A three-state partitioned survival model was developed to perform a cost-utility analysis of [177Lu]Lu-DOTA-TATE versus standard of care (high dose Octreotide LAR), everolimus and sunitinib. Effectiveness data for SoC, everolimus and sunitinib were obtained from published Kaplan–Meier survival curves. Given a lack of head-to-head effectiveness data, matching adjusted indirect comparisons (MAICs) were performed to population-adjust [177Lu]Lu-DOTA-TATE survival data based on prognostic factors and derive estimates of relative effectiveness. Health state utilities were estimated from real-world evidence. Drug acquisition costs were taken from nationally published sources (BNF, NICE), and administration costs were based on treatment protocols in [177Lu]Lu-DOTA-TATE studies, combined with nationally published unit costs (PSSRU, DoH reference costs). Incidence of adverse events were estimated using published sources. A discount rate of 3.5% was applied to both utilities and costs, and deterministic and probabilistic sensitivity analyses were performed. Costs were included from an NHS perspective and presented in 2017/18 GBP (and PPP Euros for base case). Results: In GI-NETs, the incremental cost-effectiveness ratio (ICER) of [177Lu]Lu-DOTA-TATE compared to SoC and everolimus was £26,528 (€27,672) and £24,145 (€25,186) per QALY, respectively. In P-NETs, the ICER of [177Lu]Lu-DOTA-TATE compared to SoC was £22,146 (€23,101) or £28,038 (€29,251) dependent on matched population, and £21,827 (€22,766) and £15,768 (€16,445) compared to everolimus and sunitinib, respectively. Conclusions: At a willingness to pay threshold of £30,000, [177Lu]Lu-DOTA-TATE is likely to be a cost-effective treatment option for GI-NET and P-NET patients versus relevant treatment comparators (NHS perspective). |
| first_indexed | 2024-12-20T05:23:39Z |
| format | Article |
| id | doaj.art-2b1a1faf067f47338bc56d82dd67197e |
| institution | Directory Open Access Journal |
| issn | 1359-6349 |
| language | English |
| last_indexed | 2024-12-20T05:23:39Z |
| publishDate | 2021-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EJC Supplements |
| spelling | doaj.art-2b1a1faf067f47338bc56d82dd67197e2022-12-21T19:51:57ZengElsevierEJC Supplements1359-63492021-11-01161423Use of [177Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling studyMatthew Glover0Martyn Caplin1Oscar R. Leeuwenkamp2Louise Longworth3PHMR Health Economics, Pricing and Reimbursement, London, UKRoyal Free London and University College London, UKAdvanced Accelerator Applications, a Novartis company, Geneva, Switzerland; Corresponding author:PHMR Health Economics, Pricing and Reimbursement, London, UKAim: To evaluate the cost-effectiveness of [177Lu]Lu-DOTA-TATE versus relevant comparators for the treatment of neuroendocrine tumours located in the gastrointestinal tract (GI-NETs) and the pancreas (P-NETs). Materials and methods: A three-state partitioned survival model was developed to perform a cost-utility analysis of [177Lu]Lu-DOTA-TATE versus standard of care (high dose Octreotide LAR), everolimus and sunitinib. Effectiveness data for SoC, everolimus and sunitinib were obtained from published Kaplan–Meier survival curves. Given a lack of head-to-head effectiveness data, matching adjusted indirect comparisons (MAICs) were performed to population-adjust [177Lu]Lu-DOTA-TATE survival data based on prognostic factors and derive estimates of relative effectiveness. Health state utilities were estimated from real-world evidence. Drug acquisition costs were taken from nationally published sources (BNF, NICE), and administration costs were based on treatment protocols in [177Lu]Lu-DOTA-TATE studies, combined with nationally published unit costs (PSSRU, DoH reference costs). Incidence of adverse events were estimated using published sources. A discount rate of 3.5% was applied to both utilities and costs, and deterministic and probabilistic sensitivity analyses were performed. Costs were included from an NHS perspective and presented in 2017/18 GBP (and PPP Euros for base case). Results: In GI-NETs, the incremental cost-effectiveness ratio (ICER) of [177Lu]Lu-DOTA-TATE compared to SoC and everolimus was £26,528 (€27,672) and £24,145 (€25,186) per QALY, respectively. In P-NETs, the ICER of [177Lu]Lu-DOTA-TATE compared to SoC was £22,146 (€23,101) or £28,038 (€29,251) dependent on matched population, and £21,827 (€22,766) and £15,768 (€16,445) compared to everolimus and sunitinib, respectively. Conclusions: At a willingness to pay threshold of £30,000, [177Lu]Lu-DOTA-TATE is likely to be a cost-effective treatment option for GI-NET and P-NET patients versus relevant treatment comparators (NHS perspective).http://www.sciencedirect.com/science/article/pii/S1359634921000033Gastro-enteropancreatic neuroendocrine tumours (GEP-NETs)177Lu-DOTA-octreotate[177Lu]Lu-DOTA-TATEEverolimusSunitinibQuality-Adjusted Life Years (QALYs) |
| spellingShingle | Matthew Glover Martyn Caplin Oscar R. Leeuwenkamp Louise Longworth Use of [177Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study EJC Supplements Gastro-enteropancreatic neuroendocrine tumours (GEP-NETs) 177Lu-DOTA-octreotate [177Lu]Lu-DOTA-TATE Everolimus Sunitinib Quality-Adjusted Life Years (QALYs) |
| title | Use of [177Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study |
| title_full | Use of [177Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study |
| title_fullStr | Use of [177Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study |
| title_full_unstemmed | Use of [177Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study |
| title_short | Use of [177Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study |
| title_sort | use of 177lu lu dota tate in the treatment of gastroenteropancreatic neuroendocrine tumours results of a uk cost effectiveness modelling study |
| topic | Gastro-enteropancreatic neuroendocrine tumours (GEP-NETs) 177Lu-DOTA-octreotate [177Lu]Lu-DOTA-TATE Everolimus Sunitinib Quality-Adjusted Life Years (QALYs) |
| url | http://www.sciencedirect.com/science/article/pii/S1359634921000033 |
| work_keys_str_mv | AT matthewglover useof177luludotatateinthetreatmentofgastroenteropancreaticneuroendocrinetumoursresultsofaukcosteffectivenessmodellingstudy AT martyncaplin useof177luludotatateinthetreatmentofgastroenteropancreaticneuroendocrinetumoursresultsofaukcosteffectivenessmodellingstudy AT oscarrleeuwenkamp useof177luludotatateinthetreatmentofgastroenteropancreaticneuroendocrinetumoursresultsofaukcosteffectivenessmodellingstudy AT louiselongworth useof177luludotatateinthetreatmentofgastroenteropancreaticneuroendocrinetumoursresultsofaukcosteffectivenessmodellingstudy |