Economic evaluation of ALK-TKIs in ALK-positive non-small cell lung cancer: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

XU Jiayi , DAI Zhanjing , LU Yuqiong , YANG Jing , ZHOU Wanxin , REN Ting , LU Yun ,  CHANG Feng

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing 211198, P. R. China;

Corresponding author：

CHANG Feng, Email: cpucf@163.com

Keywords：

ALK-TKIs; Non-small cell lung cancer; Economic evaluation; Systematic review

DOI：

10.7507/1672-2531.202208027

Video：

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Objective To systematically review the economic evaluations of anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitors (TKIs) in the treatment of ALK-positive non-small cell lung cancer (NSCLC). Methods PubMed, Web of Science, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect economic evaluations of ALK-TKIs in the treatment of ALK-positive NSCLC from inception to July 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, a systematic review was performed. Results A total of 20 studies were included. 18 of the included studies were cost-utility analyses based on the models. The method of survival data extrapolation involved the standard parameter model and the standard parameter model with a hazard ratio adjusting. 10 studies considered or included the disutility value of adverse events. 18 studies performed cost estimation on direct costs. In China, 45% of the included studies were first-line treatment, the results showed that ALK-TKIs were less economical than chemotherapy, and second-/third-generation ALK-TKIs were less economical than crizotinib. Only 1 studies were second-line treatment, the result showed that crizotinib was more economical than chemotherapy. Conclusion The economic evaluation results of ALK-TKIs in ALK-positive NSCLC vary according to treatment stage and national scenario, and there is also room for optimization of methodological application in this field.

Citation： XU Jiayi, DAI Zhanjing, LU Yuqiong, YANG Jing, ZHOU Wanxin, REN Ting, LU Yun, CHANG Feng. Economic evaluation of ALK-TKIs in ALK-positive non-small cell lung cancer: a systematic review. Chinese Journal of Evidence-Based Medicine, 2022, 22(12): 1428-1435. doi: 10.7507/1672-2531.202208027 Copy

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9.	Li S, Li J, Peng L, et al. Cost-effectiveness of lorlatinib as a first-line therapy for untreated advanced anaplastic lymphoma kinase-positive non-small cell lung cancer. Front Oncol, 2021, 11: 684073.
10.	Huang M, Tian Y, He M, et al. Crizotinib versus chemotherapy: a real-world cost-effectiveness study in China. J Comp Eff Res, 2020, 9(2): 93-102.
11.	Li H, Lai L, Wu B. Cost effectiveness of ceritinib and alectinib versus crizotinib in first-line anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer. Clin Drug Investig, 2020, 40(2): 183-189.
12.	Loong HH, Wong CKH, Leung LKS, et al. Cost-effectiveness analysis of ceritinib vs. crizotinib in previously untreated anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) in Hong Kong. Cost Eff Resour Alloc, 2020, 18(1): 50.
13.	母立峰, 郭咸希, 胡艳茹, 等. 克唑替尼一线治疗ALK阳性非小细胞肺癌的成本-效果分析. 中国药师, 2020, 23(6): 1119-1123.
14.	Sivignon M, Monnier R, Tehard B, et al. Cost-effectiveness of alectinib compared to crizotinib for the treatment of first-line ALK+ advanced non-small-cell lung cancer in France. PLoS One, 2020, 15(1): e0226196.
15.	Guan H, Sheng Y, Guo W, et al. Cost-effectiveness of alectinib for patients with untreated ALK-positive non-small cell lung cancer in China. Adv Ther, 2019, 36(5): 1114-1125.
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19.	张力, 周彩存, 赵军, 等. 阿来替尼一线治疗中国ALK阳性晚期或转移性非小细胞肺癌的成本效果研究. 中国医疗保险, 2019, (12): 56-62.
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21.	Zhou ZY, Mutebi A, Han S, et al. Cost-effectiveness of ceritinib in previously untreated anaplastic lymphoma kinase-positive metastatic non-small cell lung cancer in the United States. J Med Econ, 2018, 21(6): 577-586.
22.	Gourzoulidis G, Zisimopoulou O, Boubouchairopoulou N, et al. Cost-effectiveness analysis of lorlatinib in patients previously treated with anaplastic lymphoma kinase inhibitors for non-small cell lung cancer in Greece. J Health Econ Outcomes Res, 2022, 9(1): 50-57.
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24.	雷玮成, 杜宝萍, 林晓泉, 等. 克唑替尼二线治疗晚期非小细胞肺癌的成本效果分析. 今日药学, 2019, 29(4): 234-236,247.
25.	Carlson JJ, Canestaro W, Ravelo A, et al. The cost-effectiveness of alectinib in anaplastic lymphoma kinase-positive (ALK+) advanced NSCLC previously treated with crizotinib. J Med Econ, 2017, 20(7): 671-677.
26.	Hurry M, Zhou ZY, Zhang J, et al. Cost-effectiveness of ceritinib in patients previously treated with crizotinib in anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer in Canada. J Med Econ, 2016, 19(10): 936-944.
27.	Krijkamp EM, Alarid-Escudero F, Enns EA, et al. Microsimulation modeling for health decision sciences using R: a tutorial. Med Decis Making, 2018, 38(3): 400-422.

1. 仲佳. 《CSCO非小细胞肺癌诊疗指南2021》更新要点解读. 实用肿瘤杂志, 2022, 37(1): 8-15.
2. International Agency for Research on Cancer. Estimated age-standardized incidence rates (World) in 2020, all cancers, both sexes, all ages. Available at:https://gco.iarc.fr/today/home.
3. 邵岚, 张沂平. 奥希替尼治疗晚期非小细胞肺癌的疗效及影响因素. 中国新药与临床杂志, 2020, 39(3): 155-161.
4. 石远凯, 孙燕, 于金明, 等. 中国肺癌脑转移诊治专家共识(2017年版). 中国肺癌杂志, 2017, 20(1): 1-13.
5. Husereau D, Drummond M, Augustovski F, et al. Consolidated health economic evaluation reporting standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations. Appl Health Econ Health Policy, 2022, 20(2): 213-221.
6. 齐冉, 高胜男, 刘旭婷, 等. 间变性淋巴瘤激酶阳性非小细胞肺癌治疗药物经济性的系统评价. 中国药房, 2022, 33(11): 1368-1373.
7. 孙蕾, 陈平钰, 马爱霞. 劳拉替尼一线治疗间变性淋巴瘤激酶阳性晚期非小细胞肺癌的药物经济学评价. 中国药房, 2022, 33(9): 1102-1108.
8. 孙蕾, 周大创, 陈平钰, 等. 恩沙替尼一线治疗间变性淋巴瘤激酶阳性晚期非小细胞肺癌的药物经济学评价. 中国药房, 2022, 33(12): 1479-1484.
9. Li S, Li J, Peng L, et al. Cost-effectiveness of lorlatinib as a first-line therapy for untreated advanced anaplastic lymphoma kinase-positive non-small cell lung cancer. Front Oncol, 2021, 11: 684073.
10. Huang M, Tian Y, He M, et al. Crizotinib versus chemotherapy: a real-world cost-effectiveness study in China. J Comp Eff Res, 2020, 9(2): 93-102.
11. Li H, Lai L, Wu B. Cost effectiveness of ceritinib and alectinib versus crizotinib in first-line anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer. Clin Drug Investig, 2020, 40(2): 183-189.
12. Loong HH, Wong CKH, Leung LKS, et al. Cost-effectiveness analysis of ceritinib vs. crizotinib in previously untreated anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) in Hong Kong. Cost Eff Resour Alloc, 2020, 18(1): 50.
13. 母立峰, 郭咸希, 胡艳茹, 等. 克唑替尼一线治疗ALK阳性非小细胞肺癌的成本-效果分析. 中国药师, 2020, 23(6): 1119-1123.
14. Sivignon M, Monnier R, Tehard B, et al. Cost-effectiveness of alectinib compared to crizotinib for the treatment of first-line ALK+ advanced non-small-cell lung cancer in France. PLoS One, 2020, 15(1): e0226196.
15. Guan H, Sheng Y, Guo W, et al. Cost-effectiveness of alectinib for patients with untreated ALK-positive non-small cell lung cancer in China. Adv Ther, 2019, 36(5): 1114-1125.
16. Liu M, Zhang L, Huang Q, et al. Cost-effectiveness analysis of ceritinib and alectinib versus crizotinib in the treatment of anaplastic lymphoma kinase-positive advanced non-small cell lung cancer. Cancer Manag Res, 2019, 11: 9195-9202.
17. Peng Y, Ma F, Tan C, et al. Model-based economic evaluation of ceritinib and platinum-based chemotherapy as first-line treatments for advanced non-small cell lung cancer in China. Adv Ther, 2019, 36(11): 3047-3058.
18. 张龙凤, 黄棋舒, 邱玲玲, 等. 塞瑞替尼与阿来替尼一线治疗ALK阳性晚期非小细胞肺癌的成本-效用分析. 海峡药学, 2019, 31(8): 86-89.
19. 张力, 周彩存, 赵军, 等. 阿来替尼一线治疗中国ALK阳性晚期或转移性非小细胞肺癌的成本效果研究. 中国医疗保险, 2019, (12): 56-62.
20. Carlson JJ, Suh K, Orfanos P, et al. Cost effectiveness of alectinib vs. crizotinib in first-line anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer. Pharmacoeconomics, 2018, 36(4): 495-504.
21. Zhou ZY, Mutebi A, Han S, et al. Cost-effectiveness of ceritinib in previously untreated anaplastic lymphoma kinase-positive metastatic non-small cell lung cancer in the United States. J Med Econ, 2018, 21(6): 577-586.
22. Gourzoulidis G, Zisimopoulou O, Boubouchairopoulou N, et al. Cost-effectiveness analysis of lorlatinib in patients previously treated with anaplastic lymphoma kinase inhibitors for non-small cell lung cancer in Greece. J Health Econ Outcomes Res, 2022, 9(1): 50-57.
23. Nilsson FOL, Asanin ST, Masters ET, et al. The cost-effectiveness of lorlatinib versus chemotherapy as a second- or third-line treatment in anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer in Sweden. Pharmacoeconomics, 2021, 39(8): 941-952.
24. 雷玮成, 杜宝萍, 林晓泉, 等. 克唑替尼二线治疗晚期非小细胞肺癌的成本效果分析. 今日药学, 2019, 29(4): 234-236,247.
25. Carlson JJ, Canestaro W, Ravelo A, et al. The cost-effectiveness of alectinib in anaplastic lymphoma kinase-positive (ALK+) advanced NSCLC previously treated with crizotinib. J Med Econ, 2017, 20(7): 671-677.
26. Hurry M, Zhou ZY, Zhang J, et al. Cost-effectiveness of ceritinib in patients previously treated with crizotinib in anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer in Canada. J Med Econ, 2016, 19(10): 936-944.
27. Krijkamp EM, Alarid-Escudero F, Enns EA, et al. Microsimulation modeling for health decision sciences using R: a tutorial. Med Decis Making, 2018, 38(3): 400-422.

Chinese Journal of Evidence-Based Medicine

Economic evaluation of ALK-TKIs in ALK-positive non-small cell lung cancer: a systematic review

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