Cost-utility analysis of osimertinib and dacomitinib in the first-line treatment of advanced non-small cell lung cancer with EGFR mutation

To evaluate the cost-effectiveness of osimertinib compared to dacomitinib for advanced non-small cell lung cancer with EGFR mutation from the perspective of China's health system. Based on the FLAURA clinical trial and network meta-analysis, a partitioned survival model was constructed with a model simulation timeframe of 10 years and a 3-week cycle. Cost and quality-adjusted life years (QALYs) were used as model output indicators, and the incremental cost-effectiveness ratio was calculated to determine the economic feasibility of osimertinib compared to dacomitinib through cost-utility analysis. Sensitivity analysis was applied to test the robustness of the model. The basic analysis results indicate that the osimertinib group incurred an additional cost of 138,487 Chinese Yuan (CNY) compared to the dacomitinib group, but gained an additional 0.32 QALYs. The incremental cost-effectiveness ratio is 436,203 CNY, which is higher than three times China's per capita GDP. Under the threshold of three times China's per capita GDP, osimertinib appears not to be cost-effective compared to dacomitinib.