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M.G. Custodio



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    P3.07 - Poster Session with Presenters Present (ID 493)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Regional Aspects/Health Policy/Public Health
    • Presentations: 1
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      P3.07-010 - Economic Evaluation of Gefitinib vs. Erlotinib for First Line in NSCLC EGFRm under the Perspective of Brazilian Health System (ID 5068)

      14:30 - 15:45  |  Author(s): M.G. Custodio

      • Abstract
      • Slides

      Background:
      About 28,220 new cases of lung cancer are going to be diagnosed in Brazil in 2016. The epidermal growth factor receptor (EGFR) is a transmembrane protein with tyrosine kinase activity associated with growth, survival, proliferation and differentiation in different human cells. Approximately 25.5% of patients with non-small lung cancer cells (NSCLC) in Brazil present activating mutations in EGFR gene, which confers sensitivity to tyrosine kinase inhibitors (gefitinib and erlotinib).

      Methods:
      Given the similarity in efficacy observed in RCTs, an economic evaluation under the perspective of the public and private sectors in Brazil was performed using a Markov model. Estimation of direct medical costs was calculated in a group of advanced NSCLC patients with EGFR mutations, undergoing first line treatment with one of the target therapies. A discount rate of 5% was applied on future costs/benefits and the rate of adverse events was extracted from a meta-analysis to estimate its costs.

      Results:
      According to the model, patients with locally advanced or metastatic NSCLC who have EGFR activating mutations undergoing treatment firstline with gefitinib required less resource versus erlotinib in both perspectives as shown in Table 1, mainly due to the price difference between the drugs (USD 984.22 versus USD 2,033.15 in the public and USD 1,440.31 versus USD 2,439.78 in the private). Table 1. Estimated total costs for first line treatment with gefitinib or erlotinib

      Strategy Treatment Costs (USD) Incremental Costs (USD)
      Private Sector Gefitinib 26,637.12 -
      Erlotinib 42,110.00 15,472.88
      Public Sector Gefitinib 16,134.00 -
      Erlotinib 32,045.40 15,911.40
      Exchange rate 1 USD = 3.30 BRL (July/2016) Regarding costs related only to the management of adverse events, both strategies were similar in the public perspective (USD 94.15 for gefitinib versus USD 98.21 for erlotinib); however, gefitinib costs were lower than erlotinib (USD 625.27 versus USD 941.32, respectively) in the private sector.

      Conclusion:
      First line treatment with gefitinib was dominant in comparison with erlotinib for NSCLC patients with EGFR mutation in both public and private sectors in Brazil.

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