The long-term avoided recurrences and recurrence-related cost of alectinib for postoperative adjuvant therapy in Chinese patients with early-stage ALK-positive non-small cell lung cancer
Year: 2026
Type: article
Abstract: Aims: Alectinib was approved by the US, Europe and China in 2024 as the first adjuvant targeted therapy for ALK+ NSCLC, lowering risk of disease recurrence or death by 76%. Alectinib addresses a critical gap in postoperative adjuvant therapy for ALK+ NSCLC. From Chinese healthcare-system perspective, this study evaluates the impact of introducing alectinib in adjuvant therapy for stage IB (tumor ≥ 4 cm) to IIIA (UICC/AJCC 7th edition) ALK+ NSCLC on prevention of recurrence and the associated direct medical costs, compared to platinum-based chemotherapy. Methods: A Markov model was developed to estimate the number of locoregional and metastatic recurrences over a 10-year period by defining four health states: disease-free survival, locoregional recurrence, metastatic recurrence, and death. In the control group, all patients received platinum-based chemotherapy, while in the intervention group, 75% received alectinib and 25% received platinum-based chemotherapy. Clinical data were collected from open-label, randomized phase 3 trials ALINA and ALEX. Cost parameters were derived from local charges, expert consultation, and published literature. Results: Compared to control group, the intervention group would reduce recurrences by 11,300 cases over 10 years, including 3,684 locoregional and 7,616 metastatic cases. This corresponds to a 45.82% lower recurrence rate. Estimated recurrence-related cost savings amounted to 6.910 billion RMB, with 1.445 billion RMB saved from locoregional recurrences and 5.465 billion RMB from metastatic recurrences. This represents a 41.49% reduction in costs compared to control group. These findings were robust across various scenario analyses. Conclusion: Using alectinib in postoperative adjuvant therapy significantly reduces both the recurrence rate and recurrence-related treatment costs for stage IB (tumor ≥ 4 cm) to IIIA ALK+ NSCLC patients, compared to platinum-based chemotherapy. From perspective of Chinese healthcare system, this approach shows substantial potential for preventing recurrence and achieving cost savings.
Source: Frontiers in Public Health
Institutions: Fudan University, Shanghai University of Traditional Chinese Medicine, Shuguang Hospital, Shanghai Medical Information Center, First Affiliated Hospital Zhejiang University, Zhejiang University, Roche (China), Roche (Switzerland), Shandong Tumor Hospital, Shandong First Medical University, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Zhongshan Hospital
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7127941177