ArticleFrontiers in public health2026
Cost-effectiveness of first-line aumolertinib versus osimertinib for advanced epidermal growth factor receptor-mutated non-small cell lung cancer in China.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the cost-effectiveness of aumolertinib versus osimertinib as first-line treatment for advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system, and to explore economic outcomes across clinically relevant subgroups. Methods: A partitioned survival model with three health states was developed over a 10-year horizon with a 28-day cycle length. Clinical inputs were derived from indirect evidence based on the AENEAS and FLAURA trials. In the base-case analysis, the progression-free survival (PFS) effect was informed by a published simulated treatment comparison, whereas the overall survival (OS) hazard ratio for aumolertinib versus osimertinib was conservatively set at 1.00. Costs and health outcomes were discounted at 5% annually. Outcomes included total costs, quality-adjusted life-years (QALYs), and incremental net monetary benefit (iNMB) at a willingness-to-pay threshold of 298,995 Chinese Yuan (CNY) per QALY. One-way sensitivity, probabilistic sensitivity, scenario, threshold, and exploratory subgroup analyses were performed. Results: In the overall population, osimertinib was associated with a total cost of 193,447.40 CNY and 1.981 QALYs, whereas aumolertinib was associated with a total cost of 207,484.66 CNY and 2.000 QALYs. Compared with osimertinib, aumolertinib yielded an additional 0.019 QALYs at an additional cost of 14,037.26 CNY, resulting in an iNMB of -8,307.60 CNY. Thus, aumolertinib was not economically favorable in the base-case analysis. At the prespecified threshold, the probability of being cost-effective was 0.58 for osimertinib and 0.42 for aumolertinib. Scenario and threshold analyses showed that the results were sensitive to drug price and the comparative OS effect. Exploratory subgroup analyses showed differences in the direction of point estimates across subgroups, but uncertainty remained substantial across all subgroups. Conclusion: Under the current Chinese pricing environment and available indirect comparative evidence, aumolertinib and osimertinib showed broadly similar economic profiles as first-line treatment for advanced EGFR-mutated NSCLC.
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