Evidence map›Paper›PMID 37701861›Full record

ArticleClinicoEconomics and outcomes research : CEOR2023

Cost-Effectiveness of Lorlatinib for the Treatment of Adult Patients with Anaplastic Lymphoma Kinase Positive Advanced Non-Small Cell Lung Cancer in Spain.

María Presa, David Vicente, Antonio Calles, Laura Salinas-Ortega, Jaesh Naik, Luis F García, Javier Soto

Open access · goldAbstract read
In one paragraph

Article in ClinicoEconomics and outcomes research : CEOR, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.3field-weighted citation impact, top 8% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

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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

7 authors at 5 institutions in 2 countries.

María PresaHealth Economics, Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain.ORCID 0000-0001-5925-0619
David VicenteMedical Oncology Department, Hospital Universitario Virgen de Macarena, Sevilla, Spain.
Antonio CallesMedical Oncology Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain.
Laura Salinas-OrtegaHealth Economics, Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain.ORCID 0000-0002-7066-0659
Jaesh NaikHealth Economics, BresMed Health Solutions, Sheffield, UK.
Luis F GarcíaOncology Medical, Pfizer, Madrid, Spain.
Javier SotoHealth Economics & Outcomes Research, Pfizer, Madrid, Spain.ORCID 0000-0001-7726-9030
Pfizer (Spain) · ESPharmacoeconomics and Health Outcomes Research Iberia (Spain) · ESHospital General Universitario Gregorio Marañón · ESHospital Universitario Virgen Macarena · ESUniversidad Francisco de Vitoria · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: The objective of the present study was to evaluate the efficiency of lorlatinib compared to alectinib and brigatinib for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) previously not treated, in Spain. Methods: A partitioned survival model comprised progression free, non-intracranial progression, intracranial progression, and death health states was constructed to estimate the total costs, life-years gained (LYG) and quality-adjusted life years (QALYs) accumulated in a lifetime horizon. Overall survival (OS) and progression-free survival (PFS) for lorlatinib were obtained from the CROWN study. For alectinib and brigatinib, a network meta-analysis of randomized controlled trials was conducted to estimate OS and PFS hazard ratios versus crizotinib. Utilities were estimated based on EQ-5D-5L data derived from the CROWN (lorlatinib), ALEX (alectinib) and ALTA-1L (brigatinib) studies. According to the Spanish National Health Service perspective the total costs (expressed in euros using a 2021 cost year) included drug acquisition and the administration's subsequent treatment, ALK+ advanced NSCLC management and adverse-event management, and palliative care. Unitary costs were obtained from local cost databases and literature. Costs, LYGs and QALYs were discounted at 3% annually. Deterministic and probabilistic sensitivity analyses were used to test the model's robustness. Results: Lorlatinib provided higher health outcomes (+0.70 LYG/patient, +1.42 QALYs/patient) and lower costs (-€9239/patient) than alectinib. Lorlatinib yielded higher LYG (+1.74) and QALYs (+2.30) versus brigatinib but higher costs/patient (+€36,627), resulting in an incremental-cost-effectiveness-ratio of €15,912/QALY gained. Conclusion: The results of this study suggest that lorlatinib may be a dominant treatment option versus alectinib. Considering a willingness-to-pay threshold of €25,000/QALY, lorlatinib may be an efficient option compared to brigatinib.

Indexed as

advanced non-small cell lung cancerALK+cost-effectiveness analysiscost-utility analysislorlatinib

Identifiers

PMID37701861
PMCPMC10494862
OpenAlexW4386502706

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.