Limits...
Cost-effectiveness of first-line erlotinib in patients with advanced non-small-cell lung cancer unsuitable for chemotherapy.

Khan I, Morris S, Hackshaw A, Lee SM - BMJ Open (2015)

Bottom Line: The probability of cost-effectiveness of erlotinib in all patients was <10% at thresholds up to £100,000.However, within the rash subgroup, the incremental cost/QALY was £56,770/QALY with a probability of cost-effectiveness of about 80% for cost-effectiveness thresholds between £50,000 to £60,000.Erlotinib is potentially cost-effective for this population, for which few treatment options apart from best supportive care are available. (ISCRTN): 77383050.

View Article: PubMed Central - PubMed

Affiliation: CRUK & UCL Cancer Trial Centre, University College London, London, UK Department of Applied Health Research, University College London, London, UK.

No MeSH data available.


Related in: MedlinePlus

Consort diagram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4499745&req=5

BMJOPEN2014006733F1: Consort diagram.

Mentions: Between 2005 and 2009, a total of 670 (350 erlotinib; 320 placebo) patients were randomised across 78 centres in the UK. From 334 versus 313 patients who took study treatment, a prespecified subgroup of 302 erlotinib versus 278 placebo was evaluable for first cycle rash (figure 1 CONSORT). The main comparison of interest in this CE analysis is the subgroup ER (n=178) versus placebo (n=278), since overall there were no differences between erlotinib and placebo; 178/302 (59%) developed rash in the first cycle (ER group) and 124/302 (41%) took erlotinib and did not develop rash in the first cycle (Erlotinib non-rash (ENR) group); 5/313 (2%) on placebo had rash. Patients with ENR were included in a sensitivity analysis. Baseline characteristics were generally similar between groups (table 1). Although there appeared to be a difference for smoking status (except never-smokers), a multivariate analysis9 showed that overall survival was similar between ex-smokers and never-smokers (HR 0.98). Also, the efficacy of erlotinib may be reduced in patients who currently smoke, but the absolute difference of 24% versus 37% (p=0.003) does not materially impact the estimate of the QALY and ICER; and, furthermore, we have shown that efficacy is improved in the erlotinib-rash group.


Cost-effectiveness of first-line erlotinib in patients with advanced non-small-cell lung cancer unsuitable for chemotherapy.

Khan I, Morris S, Hackshaw A, Lee SM - BMJ Open (2015)

Consort diagram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499745&req=5

BMJOPEN2014006733F1: Consort diagram.
Mentions: Between 2005 and 2009, a total of 670 (350 erlotinib; 320 placebo) patients were randomised across 78 centres in the UK. From 334 versus 313 patients who took study treatment, a prespecified subgroup of 302 erlotinib versus 278 placebo was evaluable for first cycle rash (figure 1 CONSORT). The main comparison of interest in this CE analysis is the subgroup ER (n=178) versus placebo (n=278), since overall there were no differences between erlotinib and placebo; 178/302 (59%) developed rash in the first cycle (ER group) and 124/302 (41%) took erlotinib and did not develop rash in the first cycle (Erlotinib non-rash (ENR) group); 5/313 (2%) on placebo had rash. Patients with ENR were included in a sensitivity analysis. Baseline characteristics were generally similar between groups (table 1). Although there appeared to be a difference for smoking status (except never-smokers), a multivariate analysis9 showed that overall survival was similar between ex-smokers and never-smokers (HR 0.98). Also, the efficacy of erlotinib may be reduced in patients who currently smoke, but the absolute difference of 24% versus 37% (p=0.003) does not materially impact the estimate of the QALY and ICER; and, furthermore, we have shown that efficacy is improved in the erlotinib-rash group.

Bottom Line: The probability of cost-effectiveness of erlotinib in all patients was <10% at thresholds up to £100,000.However, within the rash subgroup, the incremental cost/QALY was £56,770/QALY with a probability of cost-effectiveness of about 80% for cost-effectiveness thresholds between £50,000 to £60,000.Erlotinib is potentially cost-effective for this population, for which few treatment options apart from best supportive care are available. (ISCRTN): 77383050.

View Article: PubMed Central - PubMed

Affiliation: CRUK & UCL Cancer Trial Centre, University College London, London, UK Department of Applied Health Research, University College London, London, UK.

No MeSH data available.


Related in: MedlinePlus