Cost effectiveness analysis of afatinib versus pemetrexed-cisplatin for first-line treatment of locally advanced or metastatic EGFR mutation positive non-small-cell lung cancer from the Singapore healthcare payer’s perspective

Table 7 Summary of cost and benefit in the additional scenario analysis

	Cost(SG$)	QALYs	LYs	PFLYs	ICER (SG$/QALY)
Independent model with parametric fitting^a
Weilbull
PemCis	76,679	1.54	2.38	0.66
Afatinib	92,486	1.66	2.55	1.10	129,416
Exponential
PemCis	73,775	1.53	2.37	0.71
Afatinib	92,507	1.66	2.55	1.18	143,658
Log-normal
PemCis	76,851	1.57	2.43	0.70
Afatinib	94,966	1.72	2.61	1.32	126,202
Log-logistic
PemCis	76,046	1.57	2.43	0.73
Afatinib	94,764	1.71	2.60	1.34	133,627
Pricing scenario^b
10% reduction
PemCis	75,682	1.58	2.45	0.68
Afatinib	89,880	1.69	2.59	1.18	128,348
20% reduction
PemCis	72,632	1.58	2.45	0.68
Afatinib	85,802	1.69	2.59	1.18	119,048
30% reduction
PemCis	69,583	1.58	2.45	0.68
Afatinib	81,724	1.69	2.59	1.18	109,747
40% reduction
PemCis	66,534	1.58	2.45	0.68
Afatinib	77,646	1.69	2.59	1.18	100,447
50% reduction
PemCis	63,485	1.58	2.45	0.68
Afatinib	73,568	1.69	2.59	1.18	91,147

ICER incremental cost-effectiveness ratio, QALY quality-adjusted life year, LY life year, PFLY progression-free life year, PemCis pemetrexed-cisplatin
^aProgression-free and overall survival curves of both intervention arms extrapolated from Kaplan-Meier data from trial, with parametric curve fitting from time = 0 to tail-end
^bPricing scenario with various discounting on the cost of afatinib. Afatinib was modelled in the first-line for the afatinib arm, and post-progression (second-line) for the PemCis arm, therefore the total cost of both arms reduced as a result of the reduction in selling price of afatinib

ISSN: 1471-2407