Cost-effectiveness analyses of amivantamab plus lazertinib and lazertinib versus osimertinib in non-small cell lung cancer with EGFR mutations

作者：Hui Zhang, Yueyun Li, Yuhang Liu, Haonan Li, Hong Wang · 发表于：Frontiers in Pharmacology · 年份：2025 · DOI：10.3389/fphar.2025.1527614 · 被引用次数：7 · 研究领域：Lung Cancer Treatments and Mutations、Health Systems, Economic Evaluations, Quality of Life、Cancer Immunotherapy and Biomarkers

Background The combination of amivantamab and lazertinib has demonstrated clinically significant and sustained antitumor effects in both treatment-naïve and osimertinib-pretreated advanced non-small cell lung cancer (NSCLC) patients harboring previously untreated epidermal growth factor receptor (EGFR) mutations. Objectives A cost-effectiveness analysis was conducted to compare three therapeutic strategies, namely, amivantamab with lazertinib combination therapy, lazertinib monotherapy, and osimertinib monotherapy, for advanced NSCLC patients with EGFR mutations; the patients included both treatment-naïve individuals and those previously treated with osimertinib. Methods Based on a previous multicenter randomized double-blind phase III trial (NCT04487080) for evaluating amivantamab–lazertinib versus osimertinib in EGFR-mutated advanced NSCLC patients (both treatment-naïve and osimertinib-pretreated), we constructed a Markov model for 3-week cycles over a 5-year horizon. The primary outcomes of the model included total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER), where all economic parameters were discounted at 3.0% annually. The cost-utility analyses employed China’s per capita gross domestic product for 2023 (ranging from $12,295.7 to $36,887.0) as the willingness-to-pay (WTP) threshold supplemented by comprehensive sensitivity and scenario analyses to verify the model robustness. Results The economic evaluations demonstrated t...