Cost-effectiveness of ALK testing and first-line crizotinib therapy for non-small-cell lung cancer in China.
INTRODUCTION:Anaplastic lymphoma kinase (ALK) rearrangement gene testing is used increasingly to identify patients with advanced non-small-cell lung cancer (NSCLC) who are most likely to benefit from crizotinib. This study was to evaluate the cost-effectiveness of the ALK tests followed by crizotini...
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| Format: | Article |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC6198972?pdf=render |
| _version_ | 1819055145324904448 |
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| author | Shun Lu Yongfeng Yu Shijun Fu Hongye Ren |
| author_facet | Shun Lu Yongfeng Yu Shijun Fu Hongye Ren |
| author_sort | Shun Lu |
| collection | DOAJ |
| description | INTRODUCTION:Anaplastic lymphoma kinase (ALK) rearrangement gene testing is used increasingly to identify patients with advanced non-small-cell lung cancer (NSCLC) who are most likely to benefit from crizotinib. This study was to evaluate the cost-effectiveness of the ALK tests followed by crizotinib compared to the standard chemotherapy in advanced NSCLC from the Chinese healthcare system perspective. METHODS:A 10-year Markov model was constructed to compare the costs and quality-adjusted life-years (QALYs) of crizotinib with standard chemotherapy, guided by the ALK rearrangement tests: next-generation sequencing (NGS) panel tests and multiplex polymerase chain reaction (PCR) testing. The health states included progression-free survival (PFS), progressed survival, and death. The costs examined included cost of drugs (pemetrexed, standard chemotherapy, salvage chemotherapy, and crizotinib), follow-up, palliative care, supportive care, severe adverse events, and ALK rearrangement testing. RESULTS:Under Patient Assistance Program (PAP), the model demonstrated that the patients using NGS panel tests spent US $31,388 and gained 0.780 QALYs, whereas patients using multiplex PCR spent US $31,362 and gained 0.780 QALYs, respectively. The incremental cost-effectiveness ratios of crizotinib with PAP compared to the control strategy were projected at $14,384 (NGS) and $13,740 (multiplex PCR) per QALY gained, respectively. Sensitivity analyses showed the utility of PFS and the costs of crizotinib and pemetrexed were the most impactful factors on the model outcomes. The results were robust to changes in all parameters. CONCLUSION:ALK-rearrangement test positive followed by crizotinib may be cost-effective compared to standard chemotherapy from the Chinese healthcare system perspective when PAP was available. |
| first_indexed | 2024-12-21T13:02:52Z |
| format | Article |
| id | doaj.art-5fdeb7e8957c4cebaa79be786be9fa50 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T13:02:52Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-5fdeb7e8957c4cebaa79be786be9fa502022-12-21T19:03:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011310e020582710.1371/journal.pone.0205827Cost-effectiveness of ALK testing and first-line crizotinib therapy for non-small-cell lung cancer in China.Shun LuYongfeng YuShijun FuHongye RenINTRODUCTION:Anaplastic lymphoma kinase (ALK) rearrangement gene testing is used increasingly to identify patients with advanced non-small-cell lung cancer (NSCLC) who are most likely to benefit from crizotinib. This study was to evaluate the cost-effectiveness of the ALK tests followed by crizotinib compared to the standard chemotherapy in advanced NSCLC from the Chinese healthcare system perspective. METHODS:A 10-year Markov model was constructed to compare the costs and quality-adjusted life-years (QALYs) of crizotinib with standard chemotherapy, guided by the ALK rearrangement tests: next-generation sequencing (NGS) panel tests and multiplex polymerase chain reaction (PCR) testing. The health states included progression-free survival (PFS), progressed survival, and death. The costs examined included cost of drugs (pemetrexed, standard chemotherapy, salvage chemotherapy, and crizotinib), follow-up, palliative care, supportive care, severe adverse events, and ALK rearrangement testing. RESULTS:Under Patient Assistance Program (PAP), the model demonstrated that the patients using NGS panel tests spent US $31,388 and gained 0.780 QALYs, whereas patients using multiplex PCR spent US $31,362 and gained 0.780 QALYs, respectively. The incremental cost-effectiveness ratios of crizotinib with PAP compared to the control strategy were projected at $14,384 (NGS) and $13,740 (multiplex PCR) per QALY gained, respectively. Sensitivity analyses showed the utility of PFS and the costs of crizotinib and pemetrexed were the most impactful factors on the model outcomes. The results were robust to changes in all parameters. CONCLUSION:ALK-rearrangement test positive followed by crizotinib may be cost-effective compared to standard chemotherapy from the Chinese healthcare system perspective when PAP was available.http://europepmc.org/articles/PMC6198972?pdf=render |
| spellingShingle | Shun Lu Yongfeng Yu Shijun Fu Hongye Ren Cost-effectiveness of ALK testing and first-line crizotinib therapy for non-small-cell lung cancer in China. PLoS ONE |
| title | Cost-effectiveness of ALK testing and first-line crizotinib therapy for non-small-cell lung cancer in China. |
| title_full | Cost-effectiveness of ALK testing and first-line crizotinib therapy for non-small-cell lung cancer in China. |
| title_fullStr | Cost-effectiveness of ALK testing and first-line crizotinib therapy for non-small-cell lung cancer in China. |
| title_full_unstemmed | Cost-effectiveness of ALK testing and first-line crizotinib therapy for non-small-cell lung cancer in China. |
| title_short | Cost-effectiveness of ALK testing and first-line crizotinib therapy for non-small-cell lung cancer in China. |
| title_sort | cost effectiveness of alk testing and first line crizotinib therapy for non small cell lung cancer in china |
| url | http://europepmc.org/articles/PMC6198972?pdf=render |
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