Economic Evaluation of Targeted Therapies for Anaplastic Lymphoma Kinase- and ROS1 Fusion-Positive Non-Small Cell Lung Cancer in India

被引:4
作者
Gupta, Dharna [1 ,2 ]
Gupta, Nidhi [3 ]
Singh, Navneet [4 ]
Prinja, Shankar [1 ,2 ]
机构
[1] Postgrad Inst Med Educ & Res PGIMER, Dept Community Med, Chandigarh 160012, India
[2] Postgrad Inst Med Educ & Res PGIMER, Sch Publ Hlth, Chandigarh 160012, India
[3] Govt Med Coll & Hosp, Dept Radiat Oncol, Chandigarh, India
[4] Postgrad Inst Med Educ & Res PGIMER, Dept Pulm Med, Chandigarh, India
关键词
COST-EFFECTIVENESS ANALYSIS; CRIZOTINIB; CHEMOTHERAPY; CARCINOMA; CERITINIB; CARE;
D O I
10.1200/GO.23.00260
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSE Targeted therapies, such as crizotinib and ceritinib, have shown promising results in treating non-small cell lung cancer (NSCLC) with specific oncogenic drivers like anaplastic lymphoma kinase (ALK), c-ros (ROS1) oncogene, etc. This study aims to assess the cost-effectiveness of these therapies for patients with NSCLC in India. METHODS The Markov model consisted of three health states: progression-free survival, progressive disease, and death. Lifetime costs and consequences were estimated for three treatment arms: crizotinib, ceritinib, and chemotherapy for patients with ALK- and ROS1-positive NSCLC. Incremental cost per quality-adjusted life-year (QALY) gained with crizotinib and ceritinib was compared to chemotherapy and assessed using a willingness-to-pay threshold of one-time per capita gross domestic product in India. RESULTS The total lifetime cost per patient for ALK-positive NSCLC was (sic)332,456 ($4,054 US dollars [USD]), (sic)1,284,100 ($15,659 USD), and (sic)2,337,779 ($28,509 USD) in the chemotherapy, crizotinib, and ceritinib arms, respectively. The mean QALYs lived per patient were 1.20, 2.21, and 3.34, respectively. For patients with ROS1-positive NSCLC, the total cost was (sic)323,011 ($3,939 USD) and (sic)1,763,541 ($21,507 USD) for chemotherapy and crizotinib, with mean QALYs lived per patient of 1.16 and 2.73, respectively. Nearly 92% and 81% reduction in the price of ceritinib and crizotinib is required to make it a cost-effective treatment option for ALK- and ROS1-positive NSCLC, respectively. CONCLUSION Our study findings suggest that the prices of ceritinib and crizotinib need to be reduced significantly to justify their value for inclusion in India's publicly financed health insurance scheme for treatment of patients with locally advanced/metastatic ALK- and ROS1-positive NSCLC, respectively.
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