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Budget impact of sequential treatment with first-line afatinib versus first-line osimertinib in non-small-cell lung cancer patients with common EGFR mutations

Author

Listed:
  • Lotte Westerink

    (University of Groningen
    Asc Academics Inc.)

  • Jelmer L. J. Nicolai

    (Boehringer Ingelheim BV)

  • Carl Samuelsen

    (Outcomes Analytica AS)

  • Hans J. M. Smit

    (Rijnstate Hospital Arnhem)

  • Pieter E. Postmus

    (University Medical Centre)

  • Ingolf Griebsch

    (Boehringer Ingelheim International GmbH)

  • Maarten J. Postma

    (University of Groningen
    University of Groningen
    University of Groningen)

Abstract

Background The therapeutic landscape for non-small-cell lung cancer (NSCLC) patients that have common epidermal growth factor receptor (EGFR) mutations has changed radically in the last decade. The availability of these treatment options has an economic impact, therefore a budget impact analysis was performed. Methods A budget impact analysis was conducted from a Dutch healthcare perspective over a 5-year time horizon in EGFR-mutant NSCLC patients receiving first-line afatinib (Gilotrif®) versus first-line osimertinib (Tagrisso®), followed by subsequent treatments. A decision analysis model was constructed in Excel. Scenario analyses and one-way sensitivity analysis were used to test the models’ robustness. Results Sequential treatment with afatinib versus first-line treatment with osimertinib showed mean total time on treatment (ToT) of 29.1 months versus 24.7 months, quality-adjusted life months (QALMs) of 20.2 versus 17.4 with mean cost of €108,166 per patient versus €143,251 per patient, respectively. The 5-year total budget impact was €110.4 million for the afatinib sequence versus €158.6 million for the osimertinib sequence, leading to total incremental cost savings of €48.15 million. Conclusions First-line afatinib treatment in patients with EGFR-mutant NSCLC had a lower financial impact on the Dutch healthcare budget with a higher mean ToT and QALM compared to osimertinib sequential treatment.

Suggested Citation

  • Lotte Westerink & Jelmer L. J. Nicolai & Carl Samuelsen & Hans J. M. Smit & Pieter E. Postmus & Ingolf Griebsch & Maarten J. Postma, 2020. "Budget impact of sequential treatment with first-line afatinib versus first-line osimertinib in non-small-cell lung cancer patients with common EGFR mutations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(6), pages 931-943, August.
    • Handle: RePEc:spr:eujhec:v:21:y:2020:i:6:d:10.1007_s10198-020-01186-9
    DOI: 10.1007/s10198-020-01186-9
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    References listed on IDEAS

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    1. Claxton, Karl, 1999. "The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies," Journal of Health Economics, Elsevier, vol. 18(3), pages 341-364, June.
    2. Elizabeth Wehler & Zhongyun Zhao & S. Pinar Bilir & Julie Munakata & Beth Barber, 2017. "Economic burden of toxicities associated with treating metastatic melanoma in eight countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(1), pages 49-58, January.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 3rd August 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-08-03 11:00:00

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    Cited by:

    1. Lotte Westerink & Jelmer Lennart Jens Nicolai & Maarten Jacobus Postma & Job Frank Martien Boven & Cornelis Boersma, 2022. "Cost-Effectiveness of Nintedanib for Patients with Progressive Fibrosing Interstitial Lung Disease (PF-ILD)," PharmacoEconomics - Open, Springer, vol. 6(5), pages 647-656, September.

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    More about this item

    Keywords

    Budget impact; Afatinib; Osimertinib; Treatment sequencing; I15; I18;
    All these keywords.

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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