ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1687408
Cost-effectiveness analysis of first-line gefitinib plus anlotinib treatment for patients with stage IIIB–IV EGFR-mutated NSCLC in China
Provisionally accepted
- Sichuan Cancer Hospital, Chengdu, China
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Background: The FL-ALTER study introduces a novel first-line therapeutic approach for patients with EGFR mutation-positive advanced non–small cell lung cancer (NSCLC). This study aimed to evaluate the cost-effectiveness of gefitinib in combination with anlotinib as a first-line treatment for Chinese patients diagnosed with stage IIIB–IV EGFR-mutant NSCLC. Methods: Follow-up data from the FL-ALTER trial were utilized, along with decision tree and Markov model analyses, to predict 5-year treatment cost-effectiveness. Treatment effectiveness and safety data were derived from randomized clinical trials, while cost and utility values were obtained from published literature. From the perspective of the Chinese health care system, incremental cost-effectiveness ratios (ICERs) were calculated. Sensitivity analyses were conducted for two scenarios: patient assistance programs (PAPs) and drug price negotiations. Results: Compared with treatment with gefitinib plus a placebo, treatment with gefitinib plus anlotinib resulted in an additional 0.15 quality-adjusted life years (QALYs) at an ICER of $208,618.86 per QALY. Univariate sensitivity analysis revealed that progression-free survival status utility and anlotinib cost were key factors influencing the outcomes. Probabilistic sensitivity analysis indicated that gefitinib
Keywords: Anlotinib, EGFR mutation, NSCLC, Cost-Effectiveness, targeted therapy
Received: 17 Aug 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Chen, Chen, Zhang, Chen, Yang, Jiang and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiaqi Ma, 694700826@qq.com
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