SynthesisThe European journal of health economics : HEPAC : health economics in prevention and care2020
Cost-effectiveness analysis of the first-line EGFR-TKIs in patients with non-small cell lung cancer harbouring EGFR mutations.
Synthesis in The European journal of health economics : HEPAC : health economics in prevention and care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Pharmacoeconomic Analysis of Osimertinib Compared to Earlier-Generation EGFR Inhibitors in EGFR-Mutated NSCLC: A Systematic Review.Cancer medicine · 2026Pooled it
- The economic burden of anesthetic-related adverse events: a systematic review and empirical analysis.BMC anesthesiology · 2025Pooled it
- Pooled it
- Early Cost Effectiveness of Whole-Genome Sequencing as a Clinical Diagnostic Test for Patients with Inoperable Stage IIIB,C/IV Non-squamous Non-small-Cell Lung Cancer.PharmacoEconomics · 2021Pooled it
- How are we evaluating the cost-effectiveness of companion biomarkers for targeted cancer therapies? A systematic review.BMC cancer · 2021Pooled it
- Precision in Pharmacoeconomics: A Comparative Cost-Utility Analysis of Osimertinib in EGFR-Mutant NSCLC Using Traditional and Pharmacometric Models.Therapeutic innovation & regulatory science · 2026Article
- Dacomitinib as a First-Line Therapy for Advanced EGFR-Mutated Non-Small Cell Lung Cancer Without Brain Metastases: A Multicenter Retrospective Observational Study.Cancer medicine · 2026Observational
- Buddlejasaponin IV inhibits proliferation and migration via STAT3 suppression in gefitinib-resistant non-small cell lung cancer cells.BMC complementary medicine and therapies · 2026Article
- Cost-effectiveness analysis of combined immunotherapy regimens for non-squamous non-small lung cancer after tyrosine kinase inhibitors resistance.Frontiers in public health · 2026Article
- Clinical characteristics and outcomes of advanced EGFR-mutated NSCLC treated with 45 or 30 mg starting doses of dacomitinib: a retrospective multicenter analysis.Therapeutic advances in medical oncology · 2026Article
- Cost-Effectiveness of Pembrolizumab Monotherapy for High Programmed Death Ligand 1 Advanced or Metastatic Non-small Cell Lung Cancer Depends on Long-Term Survivors.Clinical drug investigation · 2025Article
- Clinical outcome analysis of different first‑ and second‑generation EGFR‑tyrosine kinase inhibitors in untreated patients with EGFR‑mutated non‑small cell lung cancer with baseline brain metastasis.Oncology letters · 2025Article
- Cost-effectiveness of rilertinib versus osimertinib in second-line treatment in EGFR T790M resistance mutation advanced non-small cell lung cancer in China.Frontiers in pharmacology · 2025Article
- Cost-effectiveness of lazertinib as first-line treatment in patients withTherapeutic advances in medical oncology · 2025Article
- Cost-effectiveness analysis of selpercatinib versus chemotherapy and pembrolizumab in the first-line treatment of rearranged during transfection fusion-positive non-small cell lung cancer in the United States.International journal of clinical pharmacy · 2024Article
- Osimertinib in Patients With Treatment-Naive EGFR-Mutant Non-small Cell Lung Cancer: Overall Survival, Post-progression Management and Budget Impact Analysis in Real-World.The oncologist · 2024Observational
- Exploring the Cost Effectiveness of a Whole-Genome Sequencing-Based Biomarker for Treatment Selection in Patients with Advanced Lung Cancer Ineligible for Targeted Therapy.PharmacoEconomics · 2024Article
- Development and validation of a decision model for the evaluation of novel lung cancer treatments in the Netherlands.Scientific reports · 2023Article
- Utilization and costs of epidermal growth factor receptor mutation testing and targeted therapy in Medicare patients with metastatic lung adenocarcinoma.BMC health services research · 2022Article
- Towards Machine Learning-Aided Lung Cancer Clinical Routines: Approaches and Open Challenges.Journal of personalized medicine · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare the cost-effectiveness of first-line gefitinib, erlotinib, afatinib, and osimertinib in patients with non-small cell lung cancer (NSCLC) harbouring epidermal growth factor receptor (EGFR) mutations.
methodsA systematic review and network meta-analysis (NMA) were conducted to compare the relative efficacy of gefitinib, erlotinib, afatinib, and osimertinib in EGFR-mutated NSCLC. To assess the cost-effectiveness of these treatments, a Markov model was developed from Dutch societal perspective. The model was based on the clinical studies included in the NMA. Incremental costs per life-year (LY) and per quality-adjusted life-year (QALY) gained were estimated. Deterministic and probabilistic sensitivity analyses (PSA) were conducted.
resultsTotal discounted per patient costs for gefitinib, erlotinib, afatinib, and osimertinib were €65,889, €64,035, €69,418, and €131,997, and mean QALYs were 1.36, 1.39, 1.52, and 2.01 per patient, respectively. Erlotinib dominated gefitinib. Afatinib versus erlotinib yielded incremental costs of €27,058/LY and €41,504/QALY gained. Osimertinib resulted in €91,726/LY and €128,343/QALY gained compared to afatinib. PSA showed that gefitinib, erlotinib, afatinib, and osimertinib had 13%, 19%, 43%, and 26% probability to be cost-effective at a threshold of €80,000/QALY. A price reduction of osimertinib of 30% is required for osimertinib to be cost-effective at a threshold of €80,000/QALY.
conclusionsOsimertinib has a better effectiveness compared to all other TKIs. However, at a Dutch threshold of €80,000/QALY, osimertinib appears not to be cost-effective.
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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.