Pharmacoeconomic Analysis of Brigatinib versus Alectinib in First‑Line Treatment of Anaplastic Lymphoma Kinase‑Positive Advanced Non‑Small‑Cell Lung Cancer in China.
Qingqing Chai, Congling Gu, Luis Hernandez, Yan-Jun Zhang
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引用次数: 0
Abstract
Introduction: Brigatinib and alectinib are anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (ALK-TKIs) approved in China in 2022 and 2018, respectively, for the treatment of patients with ALK-positive, advanced non‑small‑cell lung cancer (NSCLC). The objective of this study is to conduct a comparative pharmacoeconomic analysis of first-line drugs, brigatinib and alectinib, in patients with ALK-positive NSCLC from the perspective of the Chinese healthcare system.
Methods: A partitioned survival model with three health states was used to simulate the health outcomes and costs of brigatinib and alectinib with a 30-year time horizon. Indirect treatment comparisons (ITC) data were used to obtain the comparative efficacy of brigatinib and alectinib, owing to lack of head-to-head trials. As the health benefits were comparable between brigatinib and alectinib on the basis of the ITCs, cost-minimization analysis (CMA) was conducted. Cost-effectiveness analyses (CEA) were also conducted as scenario analyses using the different point estimates from the ITCs. Health state utilities and costs were obtained from public sources or clinical expert opinion. Direct medical costs and quality-adjusted life years (QALYs) were discounted at an annual rate of 5%. One-way sensitivity analyses were conducted for the CMA.
Results: The CMA showed that, over 30 years, brigatinib (63,539 USD) was associated with cost savings of 14,203 USD compared with alectinib (77,742 USD). One-way sensitivity analyses showed that drug costs were the most influential parameter but brigatinib remained cost-saving in all the analyses. In the CEAs, the total cost of brigatinib was lower in all scenarios and also resulted in higher QALYs in 60% of the CEA scenarios.
Conclusions: Brigatinib was a cost-saving (14,203 USD) treatment compared with alectinib in the CMA analysis for the first-line treatment of patients with ALK-positive advanced NSCLC in China.
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