Cost-effectiveness Analysis of Lorlatinib in Patients Previously Treated with Anaplastic Lymphoma Kinase Inhibitors for Non-small Cell Lung Cancer in Greece
**Background:** Non-small cell lung cancer (NSCLC), which accounts for about 80%-85% of lungcancer cases, is a leading cause of cancer-related death worldwide. Lorlatinib is a potent third-generation anaplastic lymphoma kinase (ALK) inhibitor approved for the treatment of patients with advanced, ALK...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Columbia Data Analytics, LLC
2022-02-01
|
| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://jheor.scholasticahq.com/article/31983-cost-effectiveness-analysis-of-lorlatinib-in-patients-previously-treated-with-anaplastic-lymphoma-kinase-inhibitors-for-non-small-cell-lung-cancer-in.pdf |
| _version_ | 1818974578264768512 |
|---|---|
| author | George Gourzoulidis Oresteia Zisimopoulou Nadia Boubouchairopoulou Christina Michailidi Chrissy Lowry Charalampos Tzanetakos Georgia Kourlaba |
| author_facet | George Gourzoulidis Oresteia Zisimopoulou Nadia Boubouchairopoulou Christina Michailidi Chrissy Lowry Charalampos Tzanetakos Georgia Kourlaba |
| author_sort | George Gourzoulidis |
| collection | DOAJ |
| description | **Background:** Non-small cell lung cancer (NSCLC), which accounts for about 80%-85% of lungcancer cases, is a leading cause of cancer-related death worldwide. Lorlatinib is a potent third-generation anaplastic lymphoma kinase (ALK) inhibitor approved for the treatment of patients with advanced, ALK-positive NSCLC previously treated with at least one second-generation ALK tyrosine kinase inhibitor.
**Objective:** The present study assessed the cost-effectiveness of lorlatinib vs pemetrexed with platinum combination of carboplatin or cisplatin (P-ChT) in Greece.
**Methods:** A partitioned survival model with three health states, referring to pre-progression, progressed disease, and death, was locally adapted from a Greek payer perspective over a lifetime horizon. Clinical and safety data and utility values applied in the model were extracted from the literature. A matching-adjusted indirect comparison of lorlatinib and P-ChT was performed. Only direct medical costs (€) from 2020 were included in the analysis. Primary outcomes were patient life years (LYs), quality-adjusted life years (QALYs), total costs, and incremental cost-effectiveness ratios per QALY and LY gained. All future outcomes were discounted at 3.5% per annum. A probabilistic sensitivity analysis was conducted to account for model uncertainty.
**Results:** The analysis showed that, over a lifetime horizon, the estimated total costs of lorlatinib and P-ChT were €81 754 and €12 343, respectively. Lorlatinib was more effective than P-ChT with 2.4 and 1.5 more LYs and QALYs gained, respectively. The generated incremental cost-effectiveness ratios of lorlatinib compared with P-ChT were €28 613 per LY gained and €46 102 per QALY gained. Probabilistic sensitivity analysis confirmed the deterministic results.
**Conclusion:** The present analysis suggests that lorlatinib may be considered as a cost-effective option compared with P-ChT in Greece for the treatment of patients with advanced, ALK-positive NSCLC whose disease has progressed after at least one second-generation ALK tyrosine kinase inhibitor. In addition, this option addresses a significant unmet medical need. |
| first_indexed | 2024-12-20T15:42:17Z |
| format | Article |
| id | doaj.art-5ca95998ef6248ad99dbde981987cbc3 |
| institution | Directory Open Access Journal |
| issn | 2327-2236 |
| language | English |
| last_indexed | 2024-12-20T15:42:17Z |
| publishDate | 2022-02-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj.art-5ca95998ef6248ad99dbde981987cbc32022-12-21T19:35:07ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362022-02-01Cost-effectiveness Analysis of Lorlatinib in Patients Previously Treated with Anaplastic Lymphoma Kinase Inhibitors for Non-small Cell Lung Cancer in GreeceGeorge GourzoulidisOresteia ZisimopoulouNadia BoubouchairopoulouChristina MichailidiChrissy LowryCharalampos TzanetakosGeorgia Kourlaba**Background:** Non-small cell lung cancer (NSCLC), which accounts for about 80%-85% of lungcancer cases, is a leading cause of cancer-related death worldwide. Lorlatinib is a potent third-generation anaplastic lymphoma kinase (ALK) inhibitor approved for the treatment of patients with advanced, ALK-positive NSCLC previously treated with at least one second-generation ALK tyrosine kinase inhibitor. **Objective:** The present study assessed the cost-effectiveness of lorlatinib vs pemetrexed with platinum combination of carboplatin or cisplatin (P-ChT) in Greece. **Methods:** A partitioned survival model with three health states, referring to pre-progression, progressed disease, and death, was locally adapted from a Greek payer perspective over a lifetime horizon. Clinical and safety data and utility values applied in the model were extracted from the literature. A matching-adjusted indirect comparison of lorlatinib and P-ChT was performed. Only direct medical costs (€) from 2020 were included in the analysis. Primary outcomes were patient life years (LYs), quality-adjusted life years (QALYs), total costs, and incremental cost-effectiveness ratios per QALY and LY gained. All future outcomes were discounted at 3.5% per annum. A probabilistic sensitivity analysis was conducted to account for model uncertainty. **Results:** The analysis showed that, over a lifetime horizon, the estimated total costs of lorlatinib and P-ChT were €81 754 and €12 343, respectively. Lorlatinib was more effective than P-ChT with 2.4 and 1.5 more LYs and QALYs gained, respectively. The generated incremental cost-effectiveness ratios of lorlatinib compared with P-ChT were €28 613 per LY gained and €46 102 per QALY gained. Probabilistic sensitivity analysis confirmed the deterministic results. **Conclusion:** The present analysis suggests that lorlatinib may be considered as a cost-effective option compared with P-ChT in Greece for the treatment of patients with advanced, ALK-positive NSCLC whose disease has progressed after at least one second-generation ALK tyrosine kinase inhibitor. In addition, this option addresses a significant unmet medical need.https://jheor.scholasticahq.com/article/31983-cost-effectiveness-analysis-of-lorlatinib-in-patients-previously-treated-with-anaplastic-lymphoma-kinase-inhibitors-for-non-small-cell-lung-cancer-in.pdf |
| spellingShingle | George Gourzoulidis Oresteia Zisimopoulou Nadia Boubouchairopoulou Christina Michailidi Chrissy Lowry Charalampos Tzanetakos Georgia Kourlaba Cost-effectiveness Analysis of Lorlatinib in Patients Previously Treated with Anaplastic Lymphoma Kinase Inhibitors for Non-small Cell Lung Cancer in Greece Journal of Health Economics and Outcomes Research |
| title | Cost-effectiveness Analysis of Lorlatinib in Patients Previously Treated with Anaplastic Lymphoma Kinase Inhibitors for Non-small Cell Lung Cancer in Greece |
| title_full | Cost-effectiveness Analysis of Lorlatinib in Patients Previously Treated with Anaplastic Lymphoma Kinase Inhibitors for Non-small Cell Lung Cancer in Greece |
| title_fullStr | Cost-effectiveness Analysis of Lorlatinib in Patients Previously Treated with Anaplastic Lymphoma Kinase Inhibitors for Non-small Cell Lung Cancer in Greece |
| title_full_unstemmed | Cost-effectiveness Analysis of Lorlatinib in Patients Previously Treated with Anaplastic Lymphoma Kinase Inhibitors for Non-small Cell Lung Cancer in Greece |
| title_short | Cost-effectiveness Analysis of Lorlatinib in Patients Previously Treated with Anaplastic Lymphoma Kinase Inhibitors for Non-small Cell Lung Cancer in Greece |
| title_sort | cost effectiveness analysis of lorlatinib in patients previously treated with anaplastic lymphoma kinase inhibitors for non small cell lung cancer in greece |
| url | https://jheor.scholasticahq.com/article/31983-cost-effectiveness-analysis-of-lorlatinib-in-patients-previously-treated-with-anaplastic-lymphoma-kinase-inhibitors-for-non-small-cell-lung-cancer-in.pdf |
| work_keys_str_mv | AT georgegourzoulidis costeffectivenessanalysisoflorlatinibinpatientspreviouslytreatedwithanaplasticlymphomakinaseinhibitorsfornonsmallcelllungcanceringreece AT oresteiazisimopoulou costeffectivenessanalysisoflorlatinibinpatientspreviouslytreatedwithanaplasticlymphomakinaseinhibitorsfornonsmallcelllungcanceringreece AT nadiaboubouchairopoulou costeffectivenessanalysisoflorlatinibinpatientspreviouslytreatedwithanaplasticlymphomakinaseinhibitorsfornonsmallcelllungcanceringreece AT christinamichailidi costeffectivenessanalysisoflorlatinibinpatientspreviouslytreatedwithanaplasticlymphomakinaseinhibitorsfornonsmallcelllungcanceringreece AT chrissylowry costeffectivenessanalysisoflorlatinibinpatientspreviouslytreatedwithanaplasticlymphomakinaseinhibitorsfornonsmallcelllungcanceringreece AT charalampostzanetakos costeffectivenessanalysisoflorlatinibinpatientspreviouslytreatedwithanaplasticlymphomakinaseinhibitorsfornonsmallcelllungcanceringreece AT georgiakourlaba costeffectivenessanalysisoflorlatinibinpatientspreviouslytreatedwithanaplasticlymphomakinaseinhibitorsfornonsmallcelllungcanceringreece |