Pharmacoeconomic analysis of giotrif® (afatinib) as first-line treatment of metastatic non-small cell lung cancer with del19 mutation of epidermal growth factor receptor (EGFR) gene

Purpose of the analysis is to assess the cost-effectiveness and cost-utility of Giotrif® (afatinib) as first line treatment for metastatic non-small cell lung cancer NSCLC with Del 19mutation of EGFR gene in comparison with erlotinib, gefitinib and combination cisplatin/ pemetrexed. Markov modeling was implemented to simulate clinical and economical outcomesof different strategies in treatment of nave patients based on randomized clinical trial results. Direct medical costs were considered. Afatinib used as first line treatment in patients with NSCLC with Del 19 gene mutation increased quality-adjusted life years (QALY) by 0,354, 0,665 and 0,670 QALY in comparison with erlotinib, gefitinib and combination cisplatin/ pemetrexed respectively. The ICERs were 1 052 934, 1 067 116 и 1 064 708 rubles in comparison with erlotinib, gefitinib and combination cisplatin/ pemetrexed respectively per QALY. Afatinib was shownto be the cost-effective strategy in first line treatment of metastatic NSCLC with Del 19 gene mutation as willingness to pay threshold (1 455 741,77 rubles) was not exceeded.