Outcomes (progression-free survival and overall survival) and costs (limited to direct medical costs, from the third-party payer perspective) were collected prospectively until second progression. Costs after progression and health utilities (based on disease states and grade 3-4 toxicities) were derived from the literature.
Median overall survival, QALYs, and total costs for the erlotinib-first strategy were 3.9 months, 0.33, and 15,233, respectively, compared with 4.4 months, 0.35, and 15,363 for the chemotherapy-first strategy. There was no significant difference between the 2 strategies in term of cost-effectiveness (respectively 47,381 and 44,350 per QALY).
No difference in cost-effectiveness was found between an erlotinib-first strategy and a chemotherapy-first strategy in frail elderly patients with NSCLC.