Budget Impact Analysis of Afatinib for First-Line Treatment of Patients with Metastatic Non-Small Cell Lung Cancer with Epidermal Growth Factor Receptor Exon 19 Deletions or Exon 21 Substitution Mutations in a U.S. Health Plan

. 2018 Jun;24(6):10.18553/jmcp.2018.24.6.544. doi: 10.18553/jmcp.2018.24.6.544

Resource	Number Used per 3 Weeks^a	Unit Costs, $	Cost per 3 Weeks, $	Cost per Month, $^b	Sources and Assumptions of Unit Costs
Outpatient visits
General practitioner	0.0326	80.11	2.61	3.79	Essential RBRVS (CPT-4 99213)¹⁶
Specialist	0.1019	158.67	16.17	23.43	Essential RBRVS (CPT-4 99215)⁶
Nurse	0.0893	22.17	1.98	2.87	Essential RBRVS (CPT-4 99211)¹⁶
Physiotherapist	0.0016	22.17	0.04	0.05
Outpatient interventions
Computed tomography scan	0.0226	329.78	7.45	10.80	Essential RBRVS (CPT-4 71275)¹⁶
Magnetic resonance imaging	0.0071	437.11	3.10	4.50	Essential RBRVS (CPT-4 71555)¹⁶
Respiratory surgical procedure	0.0054	495.44	2.68	3.88	Essential RBRVS (CPT-4 32405, 76942)¹⁶
Ultrasound	0.0056	97.61	0.55	0.79	Essential RBRVS (CPT-4 76604)¹⁶
X-ray	0.0280	30.72	0.86	1.25	Essential RBRVS (CPT-4 71020)¹⁶
Radiotherapy	0.0021	378.00	0.79	1.15	Essential RBRVS (CPT-4 77385)¹⁶
Unplanned hospitalizations
Unscheduled hospitalization stay	0.0495	19,176.71	949.25	1,375.84	ICD-9-CM 162.0-162.9^c,19
Intensive care unit visit	0.0238	3,525.44	83.91	121.61	Candrilli and Mauskopf^c,21
Emergency department visit	0.0383	1,678.82	64.30	93.20	Medical Expenditure Panel Survey^c,20
Total base cost estimated for Medicare, $	1,643.16
Commercial costs estimated as 20% higher, $	1,971.79
95% CI, $	1,027.33-2,927.15

^aResource utilization information was collected from the LUX-Lung 3 trial (data on file, Boehringer Ingelheim, Health economic report: final, November 23, 2012).

^bEach number presented has been rounded to the decimal place presented. Totals are rounded after using unrounded numbers, so totals as presented may not sum exactly to their parts.

^cCosts were inflated to 2017 dollars using the medical care component of the Consumer Price Index.²³

CI = confidence interval; CPT-4 = Current Procedural Terminology, 4th Edition; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; RBRVS = Resource-Based Relative Value Scale.