Abstract 1204P
Background
In recent years, target therapies to specific molecular alterations present in non-small cell lung cancer (NSCLC) patients have been discovered and have shown superior efficacy compared to non-targeted treatments. Among the molecular alterations identified in NSCLC, the anaplastic lymphoma tyrosine kinase (ALK) receptor, present in 3.4% of patients, is one of the therapeutic targets. The aim of this study was to estimate in monetary terms the value of the benefit of ALK diagnosis in NSCLC in Spain.
Methods
A cost-benefit analysis was performed from the Spanish societal perspective with a 5-year time horizon, comparing the benefit of ALK diagnosis of NSCLC patients versus no diagnosis. Direct health care costs (DHC) (diagnosis, treatment, resource use and adverse events [AE]), direct non-health care costs (formal and informal care and travel for visits and drug administration) and indirect costs (work productivity losses [WPL] to attend visits and follow-up tests) were included. Benefits, positives and negatives, included were the stigma of a lung cancer diagnosis, quality of life (QoL) losses associated with progression and mortality, caregiver QoL, AE, time for family enjoyment, and WPL due to sick leave and premature death. The result was tested using a deterministic sensitivity analysis.
Results
An increase of €10.09m is obtained in the ALK diagnostic arm compared to the non-diagnostic arm. The cost of administration, the DHC of treating AE and the cost of formal and informal care generate savings of €265,774, €625,958 and €1.1m respectively. A benefit of €11.71m is obtained as the benefits are higher in the ALK diagnostic arm than in the non-diagnostic arm. This derives from higher patient survival and consequently lower QoL and WPL, less stigma and less loss of time for family enjoyment. The cost-benefit ratio is €1.16 (€0.90 - €2.15: the worst and the best scenario), so that for every euro invested, a social benefit of €1.16 would be obtained.
Conclusions
The results suggest that ALK diagnosis in NSCLC will not only allow patients to be treated with targeted therapies, but will also generate a benefit for Spanish society that outweighs its costs. This justifies the universal application of this diagnosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Weber.
Funding
Roche.
Disclosure
A.L. Ortega Granados: Financial Interests, Personal, Advisory Board: Roche. F. Rojo Todo: Financial Interests, Personal, Advisory Board: Roche. R. Álvarez Álvarez: Financial Interests, Personal, Advisory Board: Roche. M. Majem Tarruella: Financial Interests, Personal, Advisory Board: Roche. A. González-Domínguez: Financial Interests, Institutional, Other: Roche. Y. Ivanova Markova: Financial Interests, Institutional, Other: Roche. R. Sánchez San Cristóbal: Financial Interests, Institutional, Other: Roche. All other authors have declared no conflicts of interest.