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Published: 2026-08-25
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DOI: https://doi.org/10.52852/tcncyh.v205i8.5284
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Vol. 205 No. 8 (2026)
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Chỉnh, N. V., Hương, T. T. T., & Kiệt, P. H. T. (2026). Cost-effectiveness analysis of EGFR-TKIS for the treatment of EGFR mutation-positive non-small cell lung cancer. Journal of Medical Research, 205(8), 851-860. https://doi.org/10.52852/tcncyh.v205i8.5284

Cost-effectiveness analysis of EGFR-TKIS for the treatment of EGFR mutation-positive non-small cell lung cancer

Nguyen Van Chinh, Tran Thi Thanh Huong, Pham Huy Tuan Kiet

Main Article Content

Abstract

This study analyzed the cost-effectiveness of EGFR-Tyrosine kinase inhibitors (EGFR-TKIs) as first-line treatment for stage IV EGFR-positive non-small cell lung cancer (NSCLC). A partitioned survival model (PSM) combined with a decision tree was developed to estimate the costs, effectiveness in quality-adjusted life years (QALY), and the incremental cost-effectiveness ratio (ICER) of various EGFR-TKIs. One-way deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were performed to assess the robustness of the model. During the progression-free survival (PFS) state, total discounted treatment costs for Erlotinib, Gefitinib, Afatinib, and Osimertinib were VND 190.0 million, VND 216.8 million, VND 420.3 million, and VND 910.7 million, yielding 0.82, 0.85, 1.04, and 1.41 mean QALYs per patient, respectively. Gefitinib was excluded due to extended dominance. Compared to Erlotinib, the ICERs for Afatinib and Osimertinib were VND 1.05 billion/QALY and VND 1.22 billion/QALY, respectively. At the current threshold of VND 305.7 million/QALY, Erlotinib demonstrated the highest probability of being cost-effective (89.85%), followed by Afatinib (10.15%), while Osimertinib stood at 0%. To achieve cost-effectiveness in the Vietnamese context, Osimertinib would require a minimum price reduction of 70%. Consequently, Erlotinib remains the most cost-effective option at the current threshold. Strategic price reductions for newer-generation drugs like Osimertinib are essential to improve their affordability and accessibility to patients.

Article Details

Keywords

Cost-effectiveness, non-small cell lung cancer, EGFR-TKI, EGFR mutation

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