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Rebecca Hancock-Howard



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    P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.01-29 - <sub>Economic Analysis of Osimertinib in Previously Untreated EGFR-Positive Advanced Non-Small Cell Lung Cancer</sub> (ID 13592)

      16:45 - 18:00  |  Author(s): Rebecca Hancock-Howard

      • Abstract
      • Slides

      Background

      Osimertinib doubles progression-free survival (PFS) in previously untreated EGFR-positive advanced non-small cell lung cancer (NSCLC) patients, with remarkable intracranial response rates. However, its cost-effectiveness has not been established. We assessed the cost-effectiveness of first-line osimertinib from the perspective of the Canadian public health care payer.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A remaining lifetime Markov model was used to project the outcomes and costs of 2 treatment pathways, osimertinib or current standard-of-care (SoC) first-line EGFR TKI gefinitib or afatinib, in previously untreated EGFR-mutant advanced NSCLC patients from the health care system perspective. Clinical, health preference and cost input estimates were informed from the available literature, including second-line osimertinib after SoC failure in those with EGFR T790M mutant cancer. Model outcomes included costs (in 2017 Canadian dollars), quality-adjusted life-years (QALYs), and the incremental cost per QALY gained. The model was fully probabilistic to assess parameter uncertainty.

      4c3880bb027f159e801041b1021e88e8 Result

      Osimertinib was associated with a gain of 0.70 quality-adjusted life-years (QALYs) at an incremental cost of $58,619 vs SoC (incremental cost-effectiveness ratio [ICER]: $83,164/QALY gained). Unadjusted LY gain was 0.95. Osimertinib had a 7% probability of being cost-effective at a willingness-to-pay threshold of $50,000/QALY, and a 77% probability at a threshold of $100,000/QALY. Deterministic sensitivity analysis showed that health utilities and cost of osimertinib had the largest impact on ICER results.

      8eea62084ca7e541d918e823422bd82e Conclusion

      First-line osimertinib use in patients with advanced EGFR mutant lung cancer was found to involve a trade-off between improved PFS, QALYs and LYs versus increased cost.

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