Back to Journals » Cancer Management and Research » Volume 11

Cost-Effectiveness Analysis Of Ceritinib And Alectinib Versus Crizotinib In The Treatment Of Anaplastic Lymphoma Kinase-Positive Advanced Non-Small Cell Lung Cancer

Authors Liu M, Zhang L, Huang Q, Li N, Zheng B, Cai H

Received 16 July 2019

Accepted for publication 14 September 2019

Published 25 October 2019 Volume 2019:11 Pages 9195—9202


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Ahmet Emre Eskazan

Maobai Liu,1,* Longfeng Zhang,2,* Qishu Huang,3 Na Li,1 Bin Zheng,1 Hongfu Cai1

1Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, People’s Republic of China; 2Department of Medical Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian Province, People’s Republic of China; 3College of Pharmacy, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Hongfu Cai
Department of Pharmacy, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, People’s Republic of China

Background: This study aimed to analyze the cost-effectiveness of crizotinib versus ceritinib or alectinib as first-line-targeted drug therapy for anaplastic lymphoma kinase-positive advanced non-small cell lung cancer in China.
Methods: The Markov model was used to simulate the medical cost and quality-adjusted life years (QALYs) of patients using crizotinib, ceritinib, or alectinib over a 10-year period by establishing three health states: progression-free, post-progression, and death. Randomized controlled clinical data were collected from the open-label, randomized phase 3 trials ALEX and ASCEND-4. Cost and utility values were derived from local charges and literature. Sensitivity analyses included one-way and probabilistic sensitivity analyses.
Results: Compared with patients who used crizotinib as first-line treatment, patients in the ceritinib and alectinib groups yielded an additional 1.32 and 3.30 QALYs with an incremental cost of $84,728.20 and $339,114.36, respectively. Thus, the incremental cost-effectiveness ratio (ICER) was $64,398.83 and $102,675.74 per QALY in the ceritinib and alectinib groups, respectively. Alectinib was estimated to be more effective (4.68 QALY) and more costly ($432,063.06) with an ICER of $128,019.42 per QALY compared with ceritinib (2.69 QALY and $177,676.90). Results were robust to deterministic and probabilistic sensitivity analyses.
Conclusion: As a first-line treatment regimen, ceritinib and alectinib can extend the survival time of patients compared with crizotinib, but the medical cost also increases accordingly. According to the World Health Organization’s three-percent GDP measurement, first-line treatment with Crizotinib is the most cost-effective.

Keywords: crizotinib, ceritinib, alectinib, NSCLC, cost-effectiveness

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]