COST-EFFICACY ANALYSIS OF GEFITINIB EFFICACY IN PATIENTS WITH NON OPERABLE NON SMALL CELL LUNG CANCER
https://doi.org/10.24060/2076-3093-2012-0-2-46-52
Abstract
Drug treatment of disseminated non small cell lung cancer (NSCLC) is an actual issue today. Both clinical and economic efficacy analysis is needed for optimal therapy selection. We performed economic efficacy assessment of gefitinib (G.) therapy in patients with non operable NSCLC who hase no EGFR mutation using Markov model based on results of clinical studies conducted in N.N. Petrov Research Institute of Oncology.
G. increases overall survival of patients with NSCLC with EGFR mutation by 1,05 year. Cost/efficacy coefficient for G. in patients with EGFR mutation is 934 800 rub per 1 acquired year of life. Therapy with G just for patients with genetically proven mutation is dominating strategy when compared to therapy for all NSCLC patients irrespectively to mutation status (saving 211600 – 251800 rub per 1 patient taking into account equal clinical efficacy). Therapy with G. is economically justifying strategy when compared to chemotherapy (additional costs coefficient 960700 – 1010000 rub per 1 gained year of life). Thus, EGFR mutation testing with subsequent G. therapy in non operable NSCLC patients not only prolongs patient’s life but also has acceptable level of medical expenses.
About the Authors
S. A. ProtsenkoRussian Federation
A. V. Rudakova
Russian Federation
F. V. Moiseyenko
Russian Federation
E. V. Levchenko
Russian Federation
D. E. Matsko
Russian Federation
A. О. Ivantsov
Russian Federation
I. I. Semenov
Russian Federation
A. G. Ievleva
Russian Federation
N. V. Mitushkina
Russian Federation
A. V. Togo
Russian Federation
A. V. Novik
Russian Federation
E. N. Imyanitov
Russian Federation
V. M. Moiseyenko
Russian Federation
References
1. Государственный реестр цен на лекарственные средства, относящиеся к перечню жизненно необходимых и важнейших лекарственных средств (ЖНВЛС), по состоянию на 26 июля 2011 года || htpp: //www.ROS-MED.INFO.
2. Моисеенко В.М., Проценко С.А., Семенов И.И., Моисеенко Ф.В., Левченко Е.В., Мацко Д.E., Иванцов А.О., Иевлева А.Г., Митюшкина Н.В., Того А.В., Имянитов Е.Н. Эффективность гефитиниба в первой линии терапии неоперабельных аденокарцином лёгкого, содержащих мутацию в гене EGFR: исследование II фазы // Вопросы онкологии. – 2010. – Т. 56. – № 1. – С. 20-23.
3. Приложения к Генеральному тарифному соглашению по тарифам на медицинскую помощь (медицинские услуги) и условиям оплаты медицинской помощи, оказываемой в рамках действующей Территориальной программы обязательного медицинского страхования граждан Российской Федерации в Санкт-Петербурге на 2011 г. // Информационный портал ОМС Санкт-Петербурга. URL: http://www.spboms.ru/kiop/getdoc?doc_id=4778 (доступ 01.06.2011).
4. Ягудина Р.И. Определение «порога готовности платить» в России, в Европейских странах и в странах СНГ / Р.И. Ягудина, А.Ю. Куликов, Т. Нгуен // Современная фармакоэкономика и фармакоэпидемология. 2011. Т.4. С. 7-12.
5. Appraising life extending, end of life treatments // NICE 2008. URL: www.nice.org.uk/media/88A/F2/SupplementaryAdviceTACEoL.pdf (accessed 23.03.2012).
6. Brock D. Ethical and value issues in insurance coverage for cancer treatment // The Oncologist. 2010. Vol. 15. Suppl. 1. P. 36–42.
7. Fukuoka M. Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non–small-cell lung cancer in Asia (IPASS) / Fukuoka M., Wu Y.-L., Thongprasert S. et al. // J. Clin. Oncol. 2011. Vol. 29. P. 2866-2874.
8. Gridelli С. Gefitinib as first-line treatment for patients with advanced non-small-cell lung cancer with activating epidermal growth factor receptor mutation: Review of the evidence / С. Gridelli, F. De Marinis, M. Di Maio et al. // Lung Cancer. 2011. Vol.71. P. 249-257.
9. Horgan A. An economic analysis of the INTEREST trial, a randomized trial of docetaxel versus gefitinib as second-/third-line therapy in advanced non-small-cell lung cancer / A. Horgan, P. Bradbury, E. Amir et al. // Ann. Onc. 2011. Vol. 22. P. 1805–1811.
10. Malin J. Wrestling with the high price of cancer care: should we control costs by Individuals’ ability to pay or society’s willingness to pay? // J. Clin. Oncol. - 2010. Vol. 28. P. 3212-3214.
11. Moiseyenko V. M., Procenko S. A., Levchenko E. V., Barchuk A.S., Moiseyenko F.V., Iyevleva A.G., Mitiushkina N.V., Togo A.V., Semionov I.I., Ivantsov A.O., Matsko D.E., Imyanitov E.N. High efficacy of first-line gefitinib in non-Asian patients with EGFR-mutated lung adenocarcinoma // Onkologie. 2010. Vol. 33. №5. Р. 231-238.
12. Nadler E. S. Do oncologists believe new cancer drugs offer good value? / E.S. Nadler, B. Eckert, P. Neumann // J. Clin. Oncol. 2005. Vol. 23. Р. 6011.
13. Neumann P. Cancer therapy costs influence treatment: a national survey of oncologists/ P. Neumann, J. Palmer, E. Nadler et al. // Health Aff. 2010. Vol. 29. P. 196-202.
14. Petrelli N. Clinical Cancer Advances 2009: Major Research Advances in Cancer Treatment, Prevention, and Screening—A Report From the American Society of Clinical Oncology / N. Petrelli, E. Winer, J. Brahmer, et al. // J. Clin. Oncol. 2009. Vol. 27. P. 6052-6069.
15. Rocchi A. The role of economic evidence in Canadian oncology reimbursement decision-making: to lambda and beyond / A. Rocchi, D. Menon, S. Verma, E. Miller // Value Health. 2008. Vol. 11. P. 771–783.
16. World Health Organization. Investing in Health for Economic Development: Report of the Commission on Macroeconomics and Health. Geneva (Switzerland) // World Health Organization. 2003. URL: http:// www.who.int/macrohealth/infocentre/advocacy/en/investinginhealth02052003.pdf (accessed 23.03.2012).
Review
For citations:
Protsenko S.A., Rudakova A.V., Moiseyenko F.V., Levchenko E.V., Matsko D.E., Ivantsov A.О., Semenov I.I., Ievleva A.G., Mitushkina N.V., Togo A.V., Novik A.V., Imyanitov E.N., Moiseyenko V.M. COST-EFFICACY ANALYSIS OF GEFITINIB EFFICACY IN PATIENTS WITH NON OPERABLE NON SMALL CELL LUNG CANCER. Creative surgery and oncology. 2012;(2):46-52. (In Russ.) https://doi.org/10.24060/2076-3093-2012-0-2-46-52