Economic analysis of ALK testing and crizotinib therapy for advanced non-small-cell lung cancer.
The economic outcome of crizotinib in advanced non-small-cell lung cancer harboring anaplastic lymphoma kinase rearrangement would be investigated.



Based on a mathematical model, the economic outcome of three techniques for testing ALK gene rearrangement combing with crizotinib would be evaluated and compared with traditional regimen. The impact of the crizotinib patient assistance program (PAP) was assessed.



Ventana immunohistochemistry, quantitative real-time reverse transcription-polymerase chain reaction and IHC testing plus fluorescent in situ hybridization confirmation for anaplastic lymphoma kinase testing following crizotinib treatment leaded to the incremental cost-effectiveness ratios of US$16,820 and US$223,242, US$24,424 and US$223,271, and US$16,850 and US$254,668 per quality-adjusted life-year gained with and without PAP, respectively.



Gene-guided crizotinib therapy might be a cost-effective alternative comparing with the traditional regimen in the PAP setting.
Shanghai Lung Cancer Center, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, 241 West Huaihai Road, Shanghai, China.
Shun
S
Lu
Department of Pathology, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, 241 West Huaihai Road, Shanghai, China.
Jie
J
Zhang
Department of Clinical Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, China.
Ming
M
Ye
Eviden Health Inc., 60 Middle Sihuan Road, Beijing, China.
Baoai
B
Wang
Medical Decision & Economic Group, Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, China.
Bin
B
Wu
D000077548:Anaplastic Lymphoma Kinase; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000191:economics / Q000235:genetics*; D003362:Cost-Benefit Analysis; D000077547:Crizotinib; D015321:Gene Rearrangement; D005820:Genetic Testing / Q000191:economics*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000235:genetics*; D008483:Medical Assistance; D018803:Models, Economic; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D011720:Pyrazoles / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D011725:Pyridines / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*
D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
ALK rearrangement; cost–effectiveness; crizotinib