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Nuria Ortega



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    P2.14 - Targeted Therapy (ID 183)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Targeted Therapy
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.14-63 - Cost Analysis of the Management of CNS Metastases in Patients with Advanced ALK+ NSCLC: Alectinib vs Crizotinib (ID 2174)

      10:15 - 18:15  |  Author(s): Nuria Ortega

      • Abstract

      Background

      The high prevalence of CNS metastases in ALK+ NSCLC leads to a significant clinical and economic burden. Alectinib demonstrated superior CNS activity and significantly delayed CNS progression versus crizotinib in untreated patients. Therefore, alectinib could reduce the brain metastasis-related healthcare resource utilization and costs.

      The objective is to estimate the cost associated with the management of patients with advanced ALK+ NSCLC with and without CNS metastases, and to perform an analysis of the annual cost comparing patients treated with alectinib or crizotinib.

      Method

      Using the disaggregated consumption of resources provided by a panel of expert oncologists, the cost/year of the management of patients with ALK+ NSCLC with/without development of CNS metastases was estimated.

      The cost of management (€,2018) included the quantification of medical visits, hospitalisations, diagnostic and laboratory tests, imaging techniques and radiotherapy procedures.

      The unit costs of the resources were obtained from eSalud (Spanish database).

      Using the 12-month cumulative incidence rate of CNS metastases in the ALEX trial for alectinib (9.4%) and crizotinib (41.4%), the annual cost of management with each therapy was estimated and compared.

      An alternative analysis was performed considering the management of adverse events (AE) observed in the ALEX trial, with costs obtained from the literature.

      Result

      The cost/year of managing NSCLC was €6,173.42/patient without CNS metastases and €21,637.50/patient with CNS metastases.

      In patients treated with alectinib, the average cost per patient was lower than in patients with crizotinib (-€4,948.51 patient/year) in the Spanish healthcare setting.

      Considering the cost of AE, the average cost/year difference would be -€5,044.26/patient treated with alectinib vs crizotinib.

      figure. principal scenario results. average cost per patient treated with alectinib versus crizotinib..png

      Conclusion

      The delay in the appearance of CNS metastases associated with the treatment of alectinib vs crizotinib may result in a reduction in cost per year in the management of ALK+ NSCLC. Comprehensive approach of cost analysis should be adjusted to each disease characteristics.