Evidence map›Paper›PMID 29488070›Full record

ArticlePharmacoEconomics2018

Cost Effectiveness of Alectinib vs. Crizotinib in First-Line Anaplastic Lymphoma Kinase-Positive Advanced Non-Small-Cell Lung Cancer.

Josh J Carlson, Kangho Suh, Panos Orfanos, William Wong

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in PharmacoEconomics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05713006 (A Phase I/II Open-label Clinical Trial to Evaluate the Pharmacokinetics of Alectinib With Sequential Dose Escalation in Patients Diagnosed With ALK-rearranged Advanced Non-small Cell Lung Cancer.), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05713006 phase1 / phase2recruitingnot on this mapstarted 2022, after this paper: background citation

A Phase I/II Open-label Clinical Trial to Evaluate the Pharmacokinetics of Alectinib With Sequential Dose Escalation in Patients Diagnosed With ALK-rearranged Advanced Non-small Cell Lung Cancer.

TypeinterventionalSponsorInstituto Nacional de Cancerologia de MexicoRan2022 to 2027Enrolled45ConditionsNon-small Cell Lung Cancer Stage IIIB, ALK Gene MutationArmsAlectinib Oral Product
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Josh J CarlsonUniversity of Washington, 1959 NE Pacific St., H-375I, Box 357630, Seattle, WA, 98195-7630, USA. Carlsojj@u.washington.edu.ORCID 0000-0001-7664-8370
Kangho SuhUniversity of Washington, 1959 NE Pacific St., H-375I, Box 357630, Seattle, WA, 98195-7630, USA.
Panos OrfanosF. Hoffmann-La Roche, Ltd, Basel, Switzerland.
William WongGenentech, Inc., South San Francisco, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe recently completed ALEX trial demonstrated that alectinib improved progression-free survival, and delayed time to central nervous system progression compared with crizotinib in patients with anaplastic lymphoma kinase-positive non-small-cell lung cancer. However, the long-term clinical and economic impact of using alectinib vs. crizotinib has not been evaluated. The objective of this study was to determine the potential cost utility of alectinib vs. crizotinib from a US payer perspective.

methodsA cost-utility model was developed using partition survival methods and three health states: progression-free, post-progression, and death. ALEX trial data informed the progression-free and overall survival estimates. Costs included drug treatments and supportive care (central nervous system and non-central nervous system). Utility values were obtained from trial data and literature. Sensitivity analyses included one-way and probabilistic sensitivity analyses.

resultsTreatment with alectinib vs. crizotinib resulted in a gain of 0.91 life-years, 0.87 quality-adjusted life-years, and incremental costs of US$34,151, resulting in an incremental cost-effectiveness ratio of US$39,312/quality-adjusted life-year. Drug costs and utilities in the progression-free health state were the main drivers of the model in the one-way sensitivity analysis. From the probabilistic sensitivity analysis, alectinib had a 64% probability of being cost effective at a willingness-to-pay threshold of US$100,000/quality adjusted life-year.

conclusionsAlectinib increased time in the progression-free state and quality-adjusted life-years vs. crizotinib. The marginal cost increase was reflective of longer treatment durations in the progression-free state. Central nervous system-related costs were considerably lower with alectinib. Our results suggest that compared with crizotinib, alectinib may be a cost-effective therapy for treatment-naïve patients with anaplastic lymphoma kinase-positive non-small-cell lung cancer.

Indexed as

Anaplastic Lymphoma KinaseCarbazolesCarcinoma, Non-Small-Cell LungCost-Benefit AnalysisCrizotinibDisease-Free SurvivalDrug CostsHumansLung NeoplasmsModels, EconomicPiperidinesProtein Kinase InhibitorsQuality-Adjusted Life YearsalectinibALK protein, humanAnaplastic Lymphoma KinaseCarbazolesCrizotinibPiperidinesProtein Kinase Inhibitors

Identifiers

PMID29488070

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.