ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1698562
This article is part of the Research TopicHealth Economic Evaluation in Cancer Prevention and ControlView all 5 articles
International cost-effectiveness analysis in osimertinib after chemoradiotherapy in stage III EGFR-mutated non-small cell lung cancer
Provisionally accepted
- 1First Affiliated Hospital of University of South China, Hengyang, China
- 2Xiangya Hospital Central South University, Changsha, China
- 3Hainan General Hospital, Haikou, China
- 4Hainan Medical University, Haikou, China
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Background: The international Phase 3 LAURA trial (NCT03521154) demonstrated that the use of osimertinib following chemoradiotherapy markedly improved survival outcomes in unresectable stage ⅢNSCLC with epidermal growth factor receptor (EGFR) mutations. Considering the high cost of targeted therapy, the popularization of osimertinib in clinical practice should be considered comprehensively in terms of cost and efficacy. This study was to investigate the cost-effectiveness of osimertinib for unresectable stage ⅢEGFR-mutated NSCLC without disease progression after chemoradiotherapy from the perspective of payers in the USA and China. Methods: The main health outcomes were evaluated by measuring life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), and incremental net health benefit (INHB). An integrated Markov model with three separate health states over a 15-year horizon was established. The sensitivity of the model was assessed, and subgroup analyses were conducted. Results: Compared with placebo in stage III EGFR-mutated NSCLC after chemoradiation, osimertinib ($898,107 [3.70 QALYs] and $49,565 [3.49 QALYs]) increased costs (efficacy) by $178,953 (0.56 QALYs) in the USA and $17,872 (0.51 QALYs) in China. The corresponding ICERs were $322,308/QALY and $35,186/QALY, respectively, with an INHB of −0.63 and 0.06 QALYs. The sensitivity analysis showed that the results were influenced significantly by progression-free survival. Conclusions: In China, treatment with osimertinib rather than placebo appears to be an effective and economically accessible option for patients with stage III EGFR-mutated NSCLC with no disease progression after chemoradiotherapy. This applied especially to the eastern and central economic regions of China but not the USA currently.
Keywords: EGFR-mutated, Non-small cell lung cancer, Osimertinib, Chemoradiotherapy, Cost-Effectiveness
Received: 03 Sep 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Tang, Zou, Wei and Zhang. 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:
Chaochao Wei, wcc9058@126.com
Xiaoyu Zhang, zhangxiaoyu2004@163.com
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