Cost-benefit analysis of ALK diagnosis vs. non-diagnosis in patients with advanced non–small cell lung cancer in Spain

Year: 2022

Publisher: Glob Reg Health Technol Assess

Abstract: In recent years, therapies targeting specific molecular alterations in advanced non-small cell lung cancer (NSCLC) have been identified that have demonstrated superior efficacy to non-targeted therapies. Anaplastic lymphoma kinase (ALK) is one of the therapeutic targets; however, ALK diagnosis is not performed in all patients with NSCLC in Spain.

Therefore, the aim of this study was to estimate, in monetary terms, the benefit to Spanish society of diagnosing ALK in patients with advanced NSCLC.

A cost-benefit analysis of ALK diagnosis versus no diagnosis in patients with advanced NSCLC was carried out from the Spanish social perspective, with a time horizon of 5 years. Costs, benefits and cost-benefit ratio have been measured. The analysis considered overall survival in patients with advanced NSCLC treated with the ALKtyrosine kinase inhibitor (TKI) alectinib. The natural history of NSCLC was simulated using a Markov model. A discount rate of 3% was applied to both costs and benefits. The result was tested by deterministic sensitivity analysis.

The results justify the universal application of ALK diagnosis in advanced NSCLC, which would generate a benefit for Spanish society that would exceed its costs, allowing optimal treatment with targeted therapies for these patients.

Keywords: ALK, Cost-benefit, Cost-effectiveness, Economic evaluation, Lung cancer, Non–small cell lung cancer

How to cite: Majem, M., Álvarez, R., Ortega, A. L., Ruiz de Alda, L., Gordo, R., García, J. F., Ivanova-Markova, Y., González-Domínguez, A., Sánchez San Cristóbal, R., & Rojo, F. (2022). Cost-benefit analysis of ALK diagnosis vs. non-diagnosis in patients with advanced non–small cell lung cancer in Spain. Global & Regional Health Technology Assessment, 9(1), 82–90. https://doi.org/10.33393/grhta.2022.2449