PMID- 28115857
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 1178-6981 (Print)
IS  - 1178-6981 (Electronic)
IS  - 1178-6981 (Linking)
VI  - 9
DP  - 2017
TI  - Costs of adverse events associated with erlotinib or afatinib in first-line 
      treatment of advanced EGFR-positive non-small cell lung cancer.
PG  - 31-38
LID - 10.2147/CEOR.S121093 [doi]
AB  - OBJECTIVES: Epidermal growth factor receptor-tyrosine kinase inhibitors 
      (EGFR-TKIs) are an established treatment for advanced non-small cell lung cancer 
      (NSCLC) with EGFR mutation. According to published meta-analyses, no significant 
      efficacy differences have been demonstrated between erlotinib and afatinib. 
      However, the incidence of EGFR-TKI-related adverse events (AEs) was lower with 
      erlotinib. This study compares the cost of management of the AEs associated with 
      these two drugs from the perspective of the Spanish National Health System (NHS). 
      METHODS: The frequency of AEs was established from a recently published 
      meta-analysis. In Spain, the daily cost of both drugs can be considered similar; 
      as a result, only the costs of management of the AEs were considered. Costs and 
      resource utilization in the management of the AEs were estimated by a panel of 
      Spanish oncologists and from studies previously carried out in Spain. A 
      probabilistic analysis was performed based on a Monte Carlo simulation. RESULTS: 
      The model generated 1,000 simulations. The total cost per patient treated with 
      erlotinib and afatinib was euro657.44 and euro1,272.15, respectively. With erlotinib, 
      the cost per patient and per AE of grades </=2 and >/=3 was euro550.86 and euro106.58, 
      respectively, whereas the cost with afatinib was euro980.63 and euro291.52, 
      respectively. The reduction in the number of AEs with erlotinib could avoid a 
      mean cost for the NHS of euro614.71 (95% CI: euro342.57-881.29) per patient. 
      CONCLUSION: In advanced EGFR mutation-positive NSCLC patients, first-line 
      treatment with erlotinib could reduce health care costs for the NHS, due to a 
      decrease in the AE rate compared with afatinib. In long-term treatments, the 
      avoidance of complications and the lowering of costs associated with the 
      management of AEs are relevant factors that contribute to the sustainability of 
      the health system.
FAU - Isla, Dolores
AU  - Isla D
AD  - Medical Oncology Department, Clinical Universitary Hospital Lozano Blesa, 
      Zaragoza.
FAU - De Castro, Javier
AU  - De Castro J
AD  - Medical Oncology Department, Universitary Hospital La Paz, Madrid.
FAU - Juan, Oscar
AU  - Juan O
AD  - Medical Oncology Department, Universitary and Polytechnic Hospital La Fe, 
      Valencia.
FAU - Grau, Santiago
AU  - Grau S
AD  - Pharmacy Department, Del Mar Hospital, Barcelona.
FAU - Orofino, Javier
AU  - Orofino J
AD  - Roche Farma, S.A., Health Economics.
FAU - Gordo, Rocio
AU  - Gordo R
AD  - Roche Farma, S.A., Health Economics.
FAU - Rubio-Terres, Carlos
AU  - Rubio-Terres C
AD  - Health Value, Health Economics, Madrid, Spain.
FAU - Rubio-Rodriguez, Dario
AU  - Rubio-Rodriguez D
AD  - Health Value, Health Economics, Madrid, Spain.
LA  - eng
PT  - Journal Article
DEP - 20161230
PL  - New Zealand
TA  - Clinicoecon Outcomes Res
JT  - ClinicoEconomics and outcomes research : CEOR
JID - 101560564
PMC - PMC5221482
OTO - NOTNLM
OT  - adverse event
OT  - afatinib
OT  - cost analysis
OT  - erlotinib
OT  - non-small cell lung cancer
COIS- JO and RG are employees of Roche Farma, S.A., Madrid, Spain. CR-T and DR-R have 
      received honoraria from Roche Farma, S.A., Madrid, Spain, in connection with the 
      development of this manuscript. The authors report no other conflicts of interest 
      in this work.
EDAT- 2017/01/25 06:00
MHDA- 2017/01/25 06:01
PMCR- 2016/12/30
CRDT- 2017/01/25 06:00
PHST- 2017/01/25 06:00 [entrez]
PHST- 2017/01/25 06:00 [pubmed]
PHST- 2017/01/25 06:01 [medline]
PHST- 2016/12/30 00:00 [pmc-release]
AID - ceor-9-031 [pii]
AID - 10.2147/CEOR.S121093 [doi]
PST - epublish
SO  - Clinicoecon Outcomes Res. 2016 Dec 30;9:31-38. doi: 10.2147/CEOR.S121093. 
      eCollection 2017.