Table 1.
Variable | Base Patient Case | Low | High | Source |
---|---|---|---|---|
Overall survival, months | ||||
Carboplatin plus paclitaxel (EGFR negative or unknown) | 8.1 | 7 | 9.5 | Schiller et al21 |
Carboplatin plus pemetrexed (EGFR negative or unknown) | 12.0 | 7.6 | 17.1 | Zinner et al,22 Scagliotti et al23 |
Carboplatin, pemetrexed, and bevacizumab (EGFR negative or unknown) | 14.1 | 10.6 | 19.6 | Patel et al20 |
Erlotinib (EGFR positive) | 24.0 | 17.5 | 27.0 | Rosell et al,9 Sequist et al10 |
Progression-free survival, months | ||||
Carboplatin plus paclitaxel (EGFR negative or unknown) | 3.1 | 2.8 | 3.9 | Schiller et al21 |
Carboplatin plus pemetrexed (EGFR negative or unknown) | 5.5 | 3.4 | 8.3 | Zinner et al,22 Scagliotti et al23 |
Carboplatin, pemetrexed, and bevacizumab (EGFR negative or unknown) | 7.8 | 5.2 | 11.5 | Patel et al20 |
Erlotinib (EGFR positive) | 12.0 | 6.2 | 16.7 | Rosell et al,9 Sequist et al10 |
Health state utilities | ||||
Stable disease while receiving oral therapy | 0.670 | 0.335 | 0.080 | Carlson et al16 |
Stable disease while receiving IV chemotherapy | 0.653 | 0.327 | 0.670 | Carlson et al,16 Nafees et al24 |
Progressive disease | 0.473 | 0.237 | 0.670 | Carlson et al,16 Nafees et al24 |
Stable disease plus | ||||
Rash | 0.640 | 0.320 | 0.670 | Carlson et al,16 Nafees et al24 |
Neutropenia | 0.670 | 0.335 | 0.670 | Expert opinion |
Febrile neutropenia | 0.563 | 0.282 | 0.670 | Carlson et al,16 Nafees et al24 |
Pneumothorax | 0.630 | 0.315 | 0.670 | Expert opinion |
Hemorrhage | 0.630 | 0.315 | 0.670 | Expert opinion |
Nausea/vomiting | 0.605 | 0.303 | 0.670 | Nafees et al24 |
Neuropathy | 0.620 | 0.310 | 0.670 | Carlson et al16 |
Thrombocytopenia | 0.650 | 0.325 | 0.670 | Expert opinion |
Thrombosis | 0.563 | 0.281 | 0.670 | Expert opinion |
Probabilities | ||||
EGFR positive | 0.15 | NA | NA | Rosell et al,9 Shigematsu et al,18 Johnson et al25 |
Not enough tissue for EGFR testing | 0.50 | 0.30 | 0.70 | Mok et al,7 Tsao et al26 |
Noninformative rebiopsy | 0.15 | 0.10 | 0.25 | Expert opinion |
Pneumothorax (bronchoscopic biopsy) | 0.01 | 0.01 | 0.05 | Eberhardt et al,27 Facciolongo et al,28 Geraghty et al,29 Hergott et al30 |
Pneumothorax (transthoracic needle aspiration biopsy) | 0.09 | 0.05 | 0.15 | Geraghty et al,29 Hergott et al30 |
Hemorrhage resulting from biopsy | 0.01 | NA | NA | Facciolongo et al28 |
Carboplatin plus pemetrexed AE | ||||
Neutropenia | 0.197 | 0.080 | 0.310 | Zinner et al,22 Scagliotti et al23 |
Febrile neutropenia | 0.014 | 0.000 | 0.050 | Zinner et al,22 Scagliotti et al23 |
Thrombocytopenia | 0.085 | 0.000 | 0.160 | Zinner et al,22 Scagliotti et al23 |
Erlotinib AE | ||||
Rash | 0.060 | 0.038 | 0.082 | Genentech31 |
Carboplatin plus paclitaxel AE | ||||
Neutropenia | 0.630 | 0.574 | 0.633 | Schiller et al21 |
Febrile neutropenia | 0.040 | 0.017 | 0.063 | Schiller et al21 |
Nausea/vomiting | 0.080 | 0.049 | 0.111 | Schiller et al21 |
Neuropathy | 0.100 | 0.065 | 0.135 | Schiller et al21 |
Anemia | 0.100 | 0.065 | 0.135 | Schiller et al21 |
Carboplatin, pemetrexed, and bevacizumab AE | ||||
Anemia | 0.091 | 0.027 | 0.155 | Patel et al,20 Malhotra et al32 |
Thrombocytopenia | 0.039 | 0.000 | 0.082 | Patel et al,20 Malhotra et al32 |
Thrombosis | 0.052 | 0.002 | 0.102 | Patel et al,20 Malhotra et al32 |
Febrile neutropenia | 0.091 | 0.027 | 0.155 | Patel et al,20 Malhotra et al32 |
Cost | ||||
Erlotinib (150 mg per day for 30 days) | $4,336 | $2,168 | $6,505 | Drugstore.com33 |
Pemetrexed (per cycle) | $4,709 | $2,354 | $7,063 | Centers for Medicare & Medicaid Services34 |
Carboplatin (per cycle) | $83 | $41 | $124 | Centers for Medicare & Medicaid Services34 |
Paclitaxel (per cycle) | $86 | $43 | $129 | Drugstore.com33 |
Bevacizumab (per cycle) | $6,538 | $3,269 | $9,807 | Drugstore.com33 |
Cleocin-T gel | $105 | $52 | $157 | Drugstore.com33 |
Neupogen | $3,866 | $1,933 | $5,799 | Drugstore.com33 |
EGFR gene copy test (CPT-88368) | $243 | $122 | $365 | Centers for Medicare & Medicaid Services35 |
IV chemotherapy infusion per cycle (CPT-96413) | $335 | $168 | $503 | Centers for Medicare & Medicaid Services35 |
Transthoracic needle biopsy (CPT-32405) | $733 | $366 | $1,099 | Centers for Medicare & Medicaid Services35 |
Broncoscopic rebiopsy (CPT-31625) | $840 | $420 | $1,261 | Centers for Medicare & Medicaid Services35 |
Other biopsy (CPT-47000) | $732 | $366 | $1,098 | Centers for Medicare & Medicaid Services35 |
Chest tube (CPT-32551) | $527 | $286 | $791 | Centers for Medicare & Medicaid Services35 |
Outpatient visit (CPT-99233) | $96 | $48 | $143 | Centers for Medicare & Medicaid Services35 |
Inpatient visit (CPT-99255) | $202 | $101 | $303 | Centers for Medicare & Medicaid Services35 |
Febrile neutropenia (MS-DRG 814) | $7,057 | $3,528 | $10,585 | Centers for Medicare & Medicaid Services36 |
RBC transfusion per unit (CPT-36430) | $515 | $258 | $773 | Centers for Medicare & Medicaid Services35 |
Pyridoxine (per month) | $16 | $8 | $23 | Drugstore.com33 |
Oral ondansetron (treating one episode of vomiting) | $12 | $6 | $18 | Drugstore.com33 |
IV ondansetron (treating one episode of vomiting) | $100 | $50 | $150 | Drugstore.com33 |
Administering IV fluids | $172 | $86 | $258 | Centers for Medicare & Medicaid Services35 |
Gabapentin | $586 | $243 | $729 | Drugstore.com33 |
US/dopplers (for diagnosis of DVT CPT-93970) | $254 | $127 | $381 | Centers for Medicare & Medicaid Services35 |
Enoxaparin (per day) | $100 | $50 | $150 | Drugstore.com33 |
Rebiopsy pathology (CPT-88305 and -88342) | $271 | $136 | $407 | Centers for Medicare & Medicaid Services35 |
Disease progression per month | $5,219 | $2,610 | $7,829 | Yabroff et al,37 Bureau of Labor and Statistics38 |
Abbreviations: AE, adverse event; CPT, current procedural terminology; DVT, deep vein thrombosis; EGFR, epidermal growth factor receptor; IV, intravenous; MS-DRG, Medicare severity–diagnosis-related group; NA, not applicable.