Cost-effectiveness of first-line osimertinib plus chemotherapy versus amivantamab plus lazertinib for advanced EGFR-mutant NSCLC in the US and China.

Authors

Yihong Guo, Shixian Liu, Chuang Yang, Chengjun Wang, Rongyu Zhang, Yunfei Wang, Yanan Song, Mingfei Liu, Ruolin Zhang, Tiantian Xuan, Wen Zhao, Jisheng Li

Published in

Therapeutic advances in medical oncology. Volume 18. Pages 17588359261465356. Epub Jul 24, 2026.

Abstract

The FLAURA2 and MARIPOSA trials established survival benefits of osimertinib plus chemotherapy and amivantamab plus lazertinib, respectively, over osimertinib monotherapy in advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) sensitizing mutation.
This study aimed to evaluate the cost-effectiveness of osimertinib plus chemotherapy versus amivantamab plus lazertinib from the US and Chinese healthcare perspectives.
An economic evaluation.
A partitioned survival model with 28-day cycles was developed to simulate total costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) over a 10-year time horizon. Clinical efficacy and safety inputs were derived from FLAURA2 and MARIPOSA. Costs and utilities were sourced from public bid-winning databases, local charges, and published literature. A scenario analysis incorporated the amivantamab patient assistance program (PAP) in China. One-way and probabilistic sensitivity analyses (OWSA, PSA) assessed model uncertainty.
Compared with osimertinib monotherapy, the ICERs for osimertinib plus chemotherapy were $551,944/QALY (US) and $37,965/QALY (China). For amivantamab plus lazertinib, ICERs were $2,186,499/QALY (US) and $291,478/QALY (China). OWSA identified drug prices and utility values as key drivers. PSA indicated that in the US, osimertinib was cost-effective in 100% of simulations at a $150,000/QALY threshold. In China, at a $41,983.66/QALY threshold, osimertinib plus chemotherapy had a 74.10% probability of being cost-effective. The PAP scenario did not alter the conclusion for amivantamab plus lazertinib in China.
Based on indirect comparisons, osimertinib monotherapy is the cost-effective option for advanced EGFR-mutant NSCLC in the US. In China, osimertinib plus chemotherapy represents the optimal regimen given current pricing.

PMID:
42502359
Bibliographic data and abstract were imported from PubMed on 26 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.