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Herbert Loong
Chinese University of Hong Kong
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6607-1106
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Cost Effectiveness and Resource Allocation.
Introduction: Lower-dose ceritinib (450mg) once-daily with food was approved in 2018 in Hong Kong (HK) for first-line treatment of patients with anaplastic lymphoma kinase-positive (ALK+) advanced non-small cell lung cancer (NSCLC). This study examined the cost-effectiveness of ceritinib vs. crizotinib in the first-line treatment of ALK+ NSCLC from a HK healthcare service provider's or government's perspective.
Methods: Costs and effectiveness of first-line ceritinib vs. crizotinib over a 20-year time horizon was evaluated using a partitioned survival model with three health states (stable disease, progressed disease, and death). The efficacy data for ceritinib were obtained from a phase 3 trial comparing ceritinib with chemotherapy for advanced non-small cell lung cancer (ASCEND-4) and extrapolated using parametric survival models. Long-term survival associated with crizotinib were estimated using hazard ratio of crizotinib vs. ceritinib obtained from matching-adjusted indirect comparison based on ASCEND-4 and PROFILE 1014 trials. Drug acquisition, administration, adverse events costs, and medical costs associated with each health state were obtained from public sources and converted to 2018 US Dollars. Incremental costs per quality-adjusted-life-year (QALY) and life-year (LY) gained were estimated for ceritinib vs. crizotinib.
Results: The base case results showed that ceritinib was associated with 3.22 QALYs, 4.51 LYs, and total costs of $157,581 over 20 years. Patients receiving crizotinib had 2.68 QALYs, 3.85 LYs, and $150,424 total costs over the same time horizon. The incremental cost per QALY gained for ceritinib vs crizotinib was $13,343. Results were robust to deterministic sensitivity analyses in most scenarios.
Conclusion: Ceritinib offers a cost-effective option compared to crizotinib for previously untreated ALK+ advanced NCSLC in HK.
Keywords
advanced non-small cell lung cancer, anaplastic lymphoma kinase-positive, ceritinib, cost-effectiveness, Hong Kong
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CURRENT STATUS: Published
Version 2
Posted 14 Aug, 2020
Published
On 07 Nov, 2020
No community comments so far
Editorial decision: Accept
On 26 Oct, 2020
Review #2 received
Received 25 Oct, 2020
Reviewer #2 agreed
On 14 Oct, 2020
Reviewer #1 agreed
On 10 Oct, 2020
Review #1 received
Received 10 Oct, 2020
Reviewers invited
Invitations sent on 09 Oct, 2020
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
No comments provided
Editorial decision: Minor Revision
On 13 Jul, 2020
Review #2 received
Received 11 Jul, 2020
Reviewer #2 agreed
On 29 Jun, 2020
Review #1 received
Received 29 Jun, 2020
Reviewer #1 agreed
On 27 Jun, 2020
Reviewers invited
Invitations sent on 26 Jun, 2020
First submitted
On 16 Mar, 2020
Editor assigned
On 16 Mar, 2020
Submission checks complete
On 15 Mar, 2020
Editor invited
On 15 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
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This preprint is under consideration at Cost Effectiveness and Resource Allocation. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Herbert Loong
Chinese University of Hong Kong
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6607-1106
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 14 Aug, 2020
Published
On 07 Nov, 2020
No community comments so far
Editorial decision: Accept
On 26 Oct, 2020
Review #2 received
Received 25 Oct, 2020
Reviewer #2 agreed
On 14 Oct, 2020
Reviewer #1 agreed
On 10 Oct, 2020
Review #1 received
Received 10 Oct, 2020
Reviewers invited
Invitations sent on 09 Oct, 2020
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
No comments provided
Editorial decision: Minor Revision
On 13 Jul, 2020
Review #2 received
Received 11 Jul, 2020
Reviewer #2 agreed
On 29 Jun, 2020
Review #1 received
Received 29 Jun, 2020
Reviewer #1 agreed
On 27 Jun, 2020
Reviewers invited
Invitations sent on 26 Jun, 2020
First submitted
On 16 Mar, 2020
Editor assigned
On 16 Mar, 2020
Submission checks complete
On 15 Mar, 2020
Editor invited
On 15 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Cost Effectiveness and Resource Allocation.
Introduction: Lower-dose ceritinib (450mg) once-daily with food was approved in 2018 in Hong Kong (HK) for first-line treatment of patients with anaplastic lymphoma kinase-positive (ALK+) advanced non-small cell lung cancer (NSCLC). This study examined the cost-effectiveness of ceritinib vs. crizotinib in the first-line treatment of ALK+ NSCLC from a HK healthcare service provider's or government's perspective.
Methods: Costs and effectiveness of first-line ceritinib vs. crizotinib over a 20-year time horizon was evaluated using a partitioned survival model with three health states (stable disease, progressed disease, and death). The efficacy data for ceritinib were obtained from a phase 3 trial comparing ceritinib with chemotherapy for advanced non-small cell lung cancer (ASCEND-4) and extrapolated using parametric survival models. Long-term survival associated with crizotinib were estimated using hazard ratio of crizotinib vs. ceritinib obtained from matching-adjusted indirect comparison based on ASCEND-4 and PROFILE 1014 trials. Drug acquisition, administration, adverse events costs, and medical costs associated with each health state were obtained from public sources and converted to 2018 US Dollars. Incremental costs per quality-adjusted-life-year (QALY) and life-year (LY) gained were estimated for ceritinib vs. crizotinib.
Results: The base case results showed that ceritinib was associated with 3.22 QALYs, 4.51 LYs, and total costs of $157,581 over 20 years. Patients receiving crizotinib had 2.68 QALYs, 3.85 LYs, and $150,424 total costs over the same time horizon. The incremental cost per QALY gained for ceritinib vs crizotinib was $13,343. Results were robust to deterministic sensitivity analyses in most scenarios.
Conclusion: Ceritinib offers a cost-effective option compared to crizotinib for previously untreated ALK+ advanced NCSLC in HK.
Figure 1
Figure 2
Figure 3
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