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Trial-Based Cost-Utility Analysis of Icotinib versus Gefitinib as Second-Line Therapy for Advanced Non-Small Cell Lung Cancer in China

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  • Chunxiang Zhang
  • Hongmei Zhang
  • Jinning Shi
  • Dong Wang
  • Xiuwei Zhang
  • Jian Yang
  • Qizhi Zhai
  • Aixia Ma

Abstract

Background: Our objective is to compare the cost-utility of icotinib and gefitinib for the second-line treatment of advanced non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system. Methods: Model technology was applied to assess the data of randomized clinical trials and the direct medical costs from the perspective of the Chinese healthcare system. Five-year quality-adjusted life years (QALYs) and incremental cost-utility ratios (ICURs) were calculated. One-way and probabilistic sensitivity analyses (PSA) were performed. Results: Our model suggested that the median progression-free survival (PFS) was 4.2 months in the icotinib group and 3.5 months in the gefitinib group while they were 4.6 months and 3.4 months, respectively, in the trials. The 5-year QALYs was 0.279 in the icotinib group and 0.269 in the gefitinib group, and the according medical costs were $10662.82 and $13127.57. The ICUR/QALY of icotinib versus gefitinib presented negative in this study. The most sensitive parameter to the ICUR was utility of PFS, ranging from $-1,259,991.25 to $-182,296.61; accordingly the icotinib treatment consistently represented a dominant cost-utility strategy. Conclusions: The icotinib strategy, as a second-line therapy for advanced NSCLC patients in China, is the preferred strategy relative to gefitinib because of the dominant cost-utility. In addition, icotinib shows a good curative effect and safety, resulting in a strong demand for the Chinese market.

Suggested Citation

  • Chunxiang Zhang & Hongmei Zhang & Jinning Shi & Dong Wang & Xiuwei Zhang & Jian Yang & Qizhi Zhai & Aixia Ma, 2016. "Trial-Based Cost-Utility Analysis of Icotinib versus Gefitinib as Second-Line Therapy for Advanced Non-Small Cell Lung Cancer in China," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0151846
    DOI: 10.1371/journal.pone.0151846
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    1. Siying Wang & Liubao Peng & Jianhe Li & Xiaohui Zeng & Lihui Ouyang & Chongqing Tan & Qiong Lu, 2013. "A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-9, March.
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    Cited by:

    1. Ling Pan & Peijia Ren & Zeshui Xu, 2018. "Therapeutic Schedule Evaluation for Brain-Metastasized Non-Small Cell Lung Cancer with A Probabilistic Linguistic ELECTRE II Method," IJERPH, MDPI, vol. 15(9), pages 1-23, August.

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