title: Trial-Based Cost-Utility Analysis of Icotinib versus Gefitinib as Second-Line Therapy for Advanced Non-Small Cell Lung Cancer in China.
abstract: BACKGROUND
  Our objective is to compare the cost-utility of icotinib and gefitinib for the second-line treatment of advanced non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system.
  
  
  METHODS
  Model technology was applied to assess the data of randomized clinical trials and the direct medical costs from the perspective of the Chinese healthcare system. Five-year quality-adjusted life years (QALYs) and incremental cost-utility ratios (ICURs) were calculated. One-way and probabilistic sensitivity analyses (PSA) were performed.
  
  
  RESULTS
  Our model suggested that the median progression-free survival (PFS) was 4.2 months in the icotinib group and 3.5 months in the gefitinib group while they were 4.6 months and 3.4 months, respectively, in the trials. The 5-year QALYs was 0.279 in the icotinib group and 0.269 in the gefitinib group, and the according medical costs were $10662.82 and $13127.57. The ICUR/QALY of icotinib versus gefitinib presented negative in this study. The most sensitive parameter to the ICUR was utility of PFS, ranging from $-1,259,991.25 to $-182,296.61; accordingly the icotinib treatment consistently represented a dominant cost-utility strategy.
  
  
  CONCLUSIONS
  The icotinib strategy, as a second-line therapy for advanced NSCLC patients in China, is the preferred strategy relative to gefitinib because of the dominant cost-utility. In addition, icotinib shows a good curative effect and safety, resulting in a strong demand for the Chinese market.
authors.affiliation: School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu Province, China.|Department of Pharmacy, Nanjing Jiangning Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Chunxiang
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Blood Transfusion, Nanjing Jiangning Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Blood Transfusion, Nanjing Jiangning Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Jinning
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Blood Transfusion, Nanjing Jiangning Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Respiratory, Nanjing Jiangning Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Xiuwei
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Respiratory, Nanjing Jiangning Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Respiratory, Nanjing Jiangning Hospital, Nanjing, Jiangsu Province, China.
authors.forename: Qizhi
authors.initials: Q
authors.lastname: Zhai
authors.affiliation: School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu Province, China.
authors.forename: Aixia
authors.initials: A
authors.lastname: Ma
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000191:economics / Q000473:pathology; D002681:China; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D043844:Crown Ethers / Q000008:administration & dosage* / Q000191:economics; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008297:Male; D008390:Markov Chains; D009154:Mutation; D011799:Quinazolines / Q000008:administration & dosage* / Q000191:economics
chemical_list: D043844:Crown Ethers; D011799:Quinazolines; C531470:icotinib; D066246:ErbB Receptors; D000077156:Gefitinib