A systematic review of pharmacoeconomic evaluations of erlotinib in the first-line treatment of advanced non-small cell lung cancer

Cuc Thi Thu Nguyen (), Fabio Petrelli, Stefania Scuri, Binh Thanh Nguyen and Iolanda Grappasonni
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Cuc Thi Thu Nguyen: Hanoi University of Pharmacy
Fabio Petrelli: University of Camerino
Stefania Scuri: University of Camerino
Binh Thanh Nguyen: Hanoi University of Pharmacy
Iolanda Grappasonni: University of Camerino

The European Journal of Health Economics, 2019, vol. 20, issue 5, No 12, 763-777

Abstract: Abstract Objective To review and assess the quality of the available evidence on the cost-effectiveness of erlotinib in the first-line treatment of advanced non-small cell lung cancer (NSCLC). Methods A systematic review was conducted to identify full-text original economic evaluations of erlotinib in the first-line treatment of advanced NSCLC written in English and published from the year 2000 onwards. Study characteristics and results were recorded and compared. The quality of the studies was assessed by the Quality of Health Economic Studies (QHES) questionnaire. Results Eleven out of 130 papers were chosen for this review. Comparative regimens consisted of a best supportive care, reverse strategy, bevacizumab, cisplatin plus pemetrexed, carboplatin plus gemcitabine or gefitinib. The methods most used in these studies were modeling and sensitivity analysis and cost-effectiveness analysis. All of the studies evaluated direct costs and used quality-adjusted life-year (QALY) and life-years gained (LYG) as outcome, with 3% and 3.5% discount rate. The studies assigned ICER that ranged from dominant to I$305,510.31/QALY and from I$31,209.55/LYG to I$66,540.20/LYG. Based on the willingness to pay threshold, seven studies concluded that erlotinib was cost-effective, two studies showed that erlotinib was cost-effective on specific patients with certain conditions, and two studies comparing erlotinib with reverse strategy did not find a difference in cost-effectiveness. The high quality of these studies was confirmed using the QHES tool: the mean score was 75.77 out of 100 (SD 9.38). Conclusion Most of these high-quality studies suggested that erlotinib was cost-effective in the first-line treatment of advanced NSCLC.

Keywords: Cost-effectiveness; Overview; Report’s quality; QHES (search for similar items in EconPapers)
JEL-codes: I19 (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s10198-019-01040-7

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