Dacomitinib in first-line treatment of advanced EGFR-mutated non-small-cell lung cancer: a cost-effectiveness...

Area of Science:

• Oncology
• Pharmacoeconomics

Background:

• Advanced non-small cell lung cancer (NSCLC) with EGFR mutations requires effective first-line treatments.
• Dacomitinib and gefitinib are targeted therapies for EGFR-positive NSCLC.
• Assessing treatment cost-effectiveness is crucial for healthcare resource allocation in Spain.

Purpose of the Study:

• To evaluate the cost-effectiveness of dacomitinib versus gefitinib as a first-line treatment for newly diagnosed advanced EGFR-positive NSCLC in Spain.
• To compare the clinical and economic outcomes of these two treatment strategies.

Main Methods:

• A partitioned survival model was utilized to simulate patient outcomes.
• The model incorporated costs, utilities, and disutilities to estimate quality-adjusted life-years (QALYs).
• Incremental cost-effectiveness ratios (ICERs) were calculated for dacomitinib compared to gefitinib.

Main Results:

• Dacomitinib demonstrated higher QALYs (0.51) compared to gefitinib (0.45).
• The acquisition cost for dacomitinib was €33,061, versus €26,692 for gefitinib.
• The incremental cost-effectiveness ratio for dacomitinib was calculated at €111,048.

Conclusions:

• Dacomitinib is more effective, providing greater QALY gains than gefitinib in this patient population.
• For dacomitinib to be considered a cost-effective alternative, a discount exceeding 25% on its acquisition cost is necessary.
• These findings have implications for treatment guidelines and drug pricing in Spain.