2022 World Conference on Lung Cancer (ePosters)-EP04.01-006. A Systematic Review (SR) of Cost-effectiveness Analysis (CEA) of ALK Inhibitors (iALK) in Advance Non-small Cell Lung Cancer (NSCLC)

EP04.01-006. A Systematic Review (SR) of Cost-effectiveness Analysis (CEA) of ALK Inhibitors (iALK) in Advance Non-small Cell Lung Cancer (NSCLC)

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This systematic review examined the cost-effectiveness analysis (CEA) of ALK inhibitors (ALKi) in advanced non-small cell lung cancer (NSCLC). The availability of second and third generation ALKi has increased in recent years and has shown improvements in health outcomes. However, the financial burden of these drugs has become a concern. CEA provides information to support decision-making when there is a lack of head-to-head comparison trials for expensive drugs like ALKi.<br /><br />The review aimed to assess the quality of CEA studies on ALKi. The researchers used PRISMA guidelines to identify fully published CEA studies from 2015 to 2022 that evaluated second and third generation ALKi in NSCLC.<br /><br />Out of 103 studies, 14 were included in the review. Table 1 summarizes the findings, which showed that no studies were found on brigatinib, and 100% of the included studies used incremental cost-effectiveness ratio (ICER) per quality adjusted life year (QALY) as the main outcome. In terms of funding, 8 out of 13 studies with reported conflicts of interest (COI) had positive COI. Sensitivity analysis was performed in all studies, and drug price was identified as the main driver in 9 out of 14 studies. Studies funded by government agencies generally reported negative outcomes.<br /><br />The overall quality of the included CEA studies was deemed high. The willingness-to-pay for ALKi varied among different countries. However, the findings suggest that the cost-effectiveness of ALKi is unlikely under conventional thresholds. The authors suggest that a discount in the price of these agents may improve cost-effectiveness and allow patients access to these innovative therapies.<br /><br />Table 1 presents the frequencies of variables such as the comparator, population, perspective, threshold, willingness-to-pay, model, and funding in the included studies.<br /><br />In summary, this review highlights the high quality of CEA studies on ALKi in NSCLC. However, the findings suggest that ALKi may not be cost-effective under conventional thresholds, and a reduction in drug prices may be needed to improve access to these therapies for patients.

Asset Subtitle

Carolina Gabay

Meta Tag

Speaker Carolina Gabay

Topic Global Health, Health Services Research, and Health Economics - Cost Issues

Keywords

systematic review

cost-effectiveness analysis

ALK inhibitors

non-small cell lung cancer

second generation ALKi

third generation ALKi

health outcomes

financial burden

head-to-head comparison trials

CEA studies