Economic impact of gefitinib for refractory non-small-cell lung cancer: a Markov model-based analysis

Few data are available on the economics of target therapy for refractory non-small-cell lung cancer (NSCLC). Objective: To determine the mean global management costs (MC) per patient treated with gefitinib for NSCLC, and the costs of the different management phases. Method: A Markov approach was used to model treatment costs in a cohort of 106 patients treated with gefitinib as part of a compassionate- use program (third-line treatment) in six public-sector teaching hospitals. The economic analysis adopted the healthcare payer's perspective, and only direct costs were taken into account. Results:The mean duration of gefitinib treatment was 4.6 +/- 5.8 months (1-29 months); median survival was 4 months, 1-year and 2-year survival rates were 12.3% and 4.7%, respectively. The mean total management cost was (sic)39979 +/- 20 279. The model showed that first- and second-line treatments accounted for respectively 29.5% and 44.1% of this cost, while gefitinib periods represented 10.7%, periods of remission 1.25%, and terminal care 14.5%. A sensitivity analysis showed that the price of gefitinib had little influence on the total cost. Conclusion: The cost of third-line gefitinib therapy for NSCLC appears acceptable from the healthcare payer's perspective, but this needs to be confirmed in dedicated cost-effectiveness studies.