OBJECTIVES

: Anlotinib, a novel multitarget tyrosine kinase inhibitor, has revealed the significant efficacy compared with placebo in advanced non-small lung cancer. We aimed to assess the cost-effectiveness of anlotinib as the third-line and further therapy for this population from the Chinese payer perspective.

METHODS

:

A Markov model was performed to simulate the disease process of advanced non-small lung cancer in three states: progression-free survival (PFS), progressive disease (PD), and death. The major clinical information was derived from the ALTER 0303 trial. Cost data were calculated from the perspective of the Chinese healthcare payer. Parameters uncertainties were explored by one-way sensitivity analysis and probabilistic sensitivity analysis.

RESULTS

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Anlotinib cost $12,759.84 and yielded a survival of 0.34 QALY, while the placebo cost $3,799.80 and yielded a survival of 0.26 QALY. Therefore, the incremental cost-effectiveness ratio of anlotinib versus placebo was $112,000.5 which surpassed the willingness-to-pay threshold in China. The most influential factors of the model were utility of PFS state and the cost of anlotinib.

CONCLUSIONS

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Anlotinib is not a cost-effective regimen as the third-line and later treatment for the patients with advanced non-small cell lung cancer from the Chinese societal perspective.