Cost-Effectiveness of First-Line Immunochemotherapy Versus BRAF Plus MEK Inhibitors in BRAF V600E -Mutated Metastatic Lung Cancer.

Simple Summary: Patients with BRAFV600E-mutated metastatic lung cancer benefit from first-line BRAF plus MEK inhibitors and immune checkpoint inhibitor–chemotherapy. Nevertheless, a cost-effectiveness analysis comparing both treatments is lacking. This study suggests that despite the longer survival...

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Publicado en:Current Oncology Vol. 33; no. 7; pp. 384 - 395
Autores principales: Chen, Chian-Wei, Tsai, Jui-Hung, Tsai, Sheng-Han, Chen, Li-Jun, Yang, Szu-Chun
Formato: Journal Article
Publicado: MDPI Jul2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2026
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        10.3390/curroncol33070384
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        atl: Cost-Effectiveness of First-Line Immunochemotherapy Versus BRAF Plus MEK Inhibitors in BRAF V600E -Mutated Metastatic Lung Cancer.
      aug:
        au:
          Chen, Chian-Wei
          Tsai, Jui-Hung
          Tsai, Sheng-Han
          Chen, Li-Jun
          Yang, Szu-Chun
        affil: Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
      sug:
      ab: Simple Summary: Patients with BRAFV600E-mutated metastatic lung cancer benefit from first-line BRAF plus MEK inhibitors and immune checkpoint inhibitor–chemotherapy. Nevertheless, a cost-effectiveness analysis comparing both treatments is lacking. This study suggests that despite the longer survival of first-line immune checkpoint inhibitor–chemotherapy compared with BRAF plus MEK inhibitors, the incremental cost-effectiveness ratios (Taiwan: $73,561/QALY; US: $290,279/QALY) exceeded the respective willingness-to-pay thresholds. Namely, first-line immune checkpoint inhibitor–chemotherapy is not a cost-effective strategy for patients with BRAFV600E-mutated metastatic lung cancer. Patients with BRAFV600E-mutated metastatic lung cancer benefit from both BRAF plus MEK inhibitors and immune checkpoint inhibitor (ICI)–chemotherapy. This study evaluated the cost-effectiveness of first-line ICI–chemotherapy compared with BRAF plus MEK inhibitors in these patients. This economic analysis, with a 15-year time horizon and an annual 3% discount, was conducted from the perspective of the healthcare sectors in Taiwan and the US. Simulated patients were entered into partitioned survival models upon initiation of first-line therapies. The model inputs were derived from the FRONT-BRAF study (progression-free/overall survival, adverse events, and subsequent therapies), insurance payments or retail prices (costs of drugs, physician visits, monitoring, adverse events, and end-of-life care), and a hospital cohort (health utility). Deterministic and probabilistic analyses were performed. The incremental cost-effectiveness ratios (ICERs) of ICI–chemotherapy compared with BRAF plus MEK inhibitors (Taiwan: $73,561/QALY; US: $290,279/QALY) exceeded the willingness-to-pay (WTP) thresholds (Taiwan: $70,000/QALY; US: $150,000/QALY). The drug costs of subsequent therapies and the utility values of the progressive-disease state were the major determinants of ICERs. In Taiwan, ICI–chemotherapy had a 41.0% probability of being cost-effective at the WTP threshold. ICI–chemotherapy had a higher probability of being cost-effective than BRAF plus MEK inhibitors when the WTP exceeded $300,000/QALY in the US. Our analysis suggests that, despite the longer survival of first-line ICI–chemotherapy compared with BRAF plus MEK inhibitors, ICI–chemotherapy is not a cost-effective strategy for patients with BRAFV600E-mutated metastatic lung cancer.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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