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Title: | Use of [<sup>177</sup>Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study |
Authors: | Glover, M Caplin, M Leeuwenkamp, OR Longworth, L |
Keywords: | Gastro-enteropancreatic neuroendocrine tumours (GEP-NETs)177;177-Lu-DOTA-octreotate;[177Lu]Lu-DOTA-TATE;Everolimus;Sunitinib;Quality-Adjusted Life Years (QALYs) |
Issue Date: | 9-Nov-2021 |
Citation: | Glover, M., Caplin, M., Leeuwenkamp, O.R. and Longworth, L. (2021) 'Use of [<sup>177</sup>Lu]Lu-DOTA-TATE in the treatment of gastroenteropancreatic neuroendocrine tumours: Results of a UK cost-effectiveness modelling study', European Journal of Cancer, Supplement, 16, pp. 14 - 23. doi: 10.1016/j.ejcsup.2021.06.003. |
Abstract: | Copyright © 2021 The Author(s). Aim: To evaluate the cost-effectiveness of [177Lu]Lu-DOTA-TATE versus relevant comparators for the treatment of neuroendocrine tumours located in the gastrointestinal tract (GI-NETs) and the pancreas (P-NETs). Materials and methods: A three-state partitioned survival model was developed to perform a cost-utility analysis of [177Lu]Lu-DOTA-TATE versus standard of care (high dose Octreotide LAR), everolimus and sunitinib. Effectiveness data for SoC, everolimus and sunitinib were obtained from published Kaplan–Meier survival curves. Given a lack of head-to-head effectiveness data, matching adjusted indirect comparisons (MAICs) were performed to population-adjust [177Lu]Lu-DOTA-TATE survival data based on prognostic factors and derive estimates of relative effectiveness. Health state utilities were estimated from real-world evidence. Drug acquisition costs were taken from nationally published sources (BNF, NICE), and administration costs were based on treatment protocols in [177Lu]Lu-DOTA-TATE studies, combined with nationally published unit costs (PSSRU, DoH reference costs). Incidence of adverse events were estimated using published sources. A discount rate of 3.5% was applied to both utilities and costs, and deterministic and probabilistic sensitivity analyses were performed. Costs were included from an NHS perspective and presented in 2017/18 GBP (and PPP Euros for base case). Results: In GI-NETs, the incremental cost-effectiveness ratio (ICER) of [177Lu]Lu-DOTA-TATE compared to SoC and everolimus was £26,528 (€27,672) and £24,145 (€25,186) per QALY, respectively. In P-NETs, the ICER of [177Lu]Lu-DOTA-TATE compared to SoC was £22,146 (€23,101) or £28,038 (€29,251) dependent on matched population, and £21,827 (€22,766) and £15,768 (€16,445) compared to everolimus and sunitinib, respectively. Conclusions: At a willingness to pay threshold of £30,000, [177Lu]Lu-DOTA-TATE is likely to be a cost-effective treatment option for GI-NET and P-NET patients versus relevant treatment comparators (NHS perspective). |
URI: | https://bura.brunel.ac.uk/handle/2438/23641 |
DOI: | https://doi.org/10.1016/j.ejcsup.2021.06.003 |
ISSN: | 1359-6349 |
Appears in Collections: | Dept of Health Sciences Research Papers |
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