Cost-benefit analysis of ALK diagnosis vs. non-diagnosis in patients with advanced non–small cell lung cancer in Spain
Open Access
- 12 September 2022
- journal article
- research article
- Published by Aboutscience Srl in Global and Regional Health Technology Assessment
- Vol. 9, 82-90
- https://doi.org/10.33393/grhta.2022.2449
Abstract
Introduction: In recent years, target therapies to specific molecular alterations in advanced non–small cell lung cancer (NSCLC) have been identified and have shown superior efficacy compared to non-targeted treatments. Anaplastic lymphoma kinase (ALK) is one of the therapeutic targets; nevertheless, ALK diagnosis is not performed in all NSCLC patients in Spain. The objective of this study is to estimate in monetary terms the benefit for the Spanish society of ALK diagnosis in advanced NSCLC patients. Methods: A cost-benefit analysis of ALK diagnosis vs. non-diagnosis in advanced NSCLC patients was carried out from the Spanish social perspective, with a time horizon of 5 years. Costs, benefits and the cost-benefit ratio weremeasured. The analysis has considered the overall survival in advanced NSCLC patients treated with the ALKtyrosine kinase inhibitor (TKI) alectinib. The natural history of NSCLC was simulated using a Markov model. A 3% discount rate was applied to both costs and benefits. The result was tested using a deterministic sensitivity analysis. Results: The cost of ALK diagnosis vs. non-diagnosis in the base case would be €10.19 million, generating benefits of €11.71 million. The cost-benefit ratio would be €1.15. In the sensitivity analysis, the cost-benefit ratio could range from €0.89 to €2.10. Conclusions: The results justify the universal application of ALK diagnosis in advanced NSCLC, which generates a benefit for Spanish society that outweighs its costs and allows optimal treatment with targeted therapies for these patients.Keywords
This publication has 45 references indexed in Scilit:
- Family Caregiver Burden, Skills Preparedness, and Quality of Life in Non-Small Cell Lung CancerOncology Nursing Forum, 2013
- Societal savings in patients with advanced non-squamous non-small-cell lung cancer receiving bevacizumab-based versus non-bevacizumab-based treatments in France, Germany, Italy, and SpainClinicoEconomics and Outcomes Research, 2012
- Age-dependent decline in renal function in patients with lung cancerOncology Letters, 2012
- Can This Patient Be Discharged Home? Factors Associated With At-Home Death Among Patients With CancerJournal of Clinical Oncology, 2011
- Anaplastic Lymphoma Kinase Inhibition in Non–Small-Cell Lung CancerThe New England Journal of Medicine, 2010
- Propuesta de guía para la evaluación económica aplicada a las tecnologías sanitariasGaceta Sanitaria, 2010
- Health state utilities for non small cell lung cancerHealth and Quality of Life Outcomes, 2008
- Paclitaxel and gemcitabine versus carboplatin and gemcitabine in patients with advanced non-small-cell lung cancer. A phase III study of the Hellenic Cooperative Oncology GroupAnnals of Oncology, 2007
- Vinorelbine/carboplatin vs gemcitabine/carboplatin in advanced NSCLC shows similar efficacy, but different impact of toxicityBritish Journal of Cancer, 2007
- Sequential two-line strategy for stage IV non-small-cell lung cancer: docetaxel–cisplatin versus vinorelbine–cisplatin followed by cross-over to single-agent docetaxel or vinorelbine at progression: final results of a randomised phase II studyAnnals of Oncology, 2005