Cost-Utility Analysis of Crizotinib as First Line Medication on Late Stage ALK Positive Non-Small Cell Lung Cancer Patients in Taiwan

Purpose: This study aimed to estimate the cost-utility of Crizotinib treatment as first-line medication on late stage ALK positive non-small-cell lung cancer patients compare to current chemotherapy from the payer’s perspective in Taiwan. Methods: A cost-utility analysis was conducted using a Markov model from the National Health Insurance Administrative perspective. Real-world data and costs were obtained from National Health Insurance Reasearch Database to calculate the progression-free survival and overall survival of late stage NSCLC patients using chemotherapy as main treatment strategy. Then, hazard ratios from literature review were used to simulate the survival conditions seperately for late stage ALK positive NSCLC patients using Crizotinib treatment or chemotherapy. Results: Compared to chemotherapy, late stage ALK positive NSCLC patients using Crizotinib treatment as first-line medication resulted in gaining 0.807 life-years (LYs) and 0.440 quality-adjusted life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was NT$2,565,058.0 per LY gained and NT$4,698,269.3 per QALY gained.