Evidence mapPaperPMID 42484063Full record

SynthesisCancer medicine2026

Pharmacoeconomic Analysis of Osimertinib Compared to Earlier-Generation EGFR Inhibitors in EGFR-Mutated NSCLC: A Systematic Review.

Nicola Perrotta, Adriana Coluccia, Francesca Rossi, Giulia Amato, Giacomo Polito

Abstract readSystematic ReviewComparative Study
In one paragraph

Synthesis in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nicola PerrottaPoliclinico Umberto I Hospital, Sapienza University, Rome, Italy.ORCID https://orcid.org/0000-0002-0809-5118
Adriana ColucciaPoliclinico Umberto I Hospital, Sapienza University, Rome, Italy.
Francesca RossiPoliclinico Umberto I Hospital, Sapienza University, Rome, Italy.
Giulia AmatoDepartment of Chemistry and Technology of Drugs, Sapienza University, Rome, Italy.
Giacomo PolitoPoliclinico Umberto I Hospital, Sapienza University, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOsimertinib has reshaped the treatment of EGFR-mutated non-small cell lung cancer (NSCLC), but its high cost raises persistent questions about value for money.

objectivesTo review economic evaluations of osimertinib in EGFR-mutated NSCLC and identify the drivers of cost-effectiveness across first-line, second-line/sequential, and adjuvant settings in North America and Europe.

methodsThis review was registered with PROSPERO (CRD420251139947) and conducted in accordance with PRISMA 2020. We searched PubMed/MEDLINE, Embase, Web of Science Core Collection, and the Cochrane Library through August 2025 for peer-reviewed economic evaluations comparing osimertinib with chemotherapy or earlier-generation EGFR tyrosine kinase inhibitors from a payer perspective. Reporting quality was appraised with CHEERS 2022. Given heterogeneity in models, pricing, and survival extrapolation, results were synthesized narratively, each incremental cost-effectiveness ratio (ICER) interpreted against its own jurisdiction's willingness-to-pay (WTP) threshold.

resultsNine studies published between 2018 and 2024 were included. First-line osimertinib improved outcomes but at ICERs of $151,922-$231,123/QALY (US) and €128,343-€273,895/QALY (Europe), exceeding local thresholds. Second-line T790M-positive estimates were favorable and context-dependent ($159,126/QALY US; £41,705/QALY UK under end-of-life criteria). Adjuvant results were most divergent: cost-effective under cure-fraction assumptions but unfavorable when benefit was modeled as delayed recurrence. Price, overall-survival (OS) extrapolation, sequencing, and local WTP thresholds were dominant.

conclusionsOsimertinib confers meaningful clinical benefit, but its value for money is context-specific and often uncertain at current list prices. These conclusions rest on few heterogeneous models and warrant caution; sustainable use will depend on price reductions, patient prioritization, maturation of OS data, and outcome-based reimbursement.

Indexed as

AcrylamidesAniline CompoundsAntineoplastic AgentsCarcinoma, Non-Small-Cell LungLung NeoplasmsProtein Kinase InhibitorsCost-Benefit AnalysisCost-Effectiveness AnalysisEconomics, PharmaceuticalErbB ReceptorsHumansIndolesMutationPyrimidinesAcrylamidesAniline CompoundsAntineoplastic AgentsEGFR protein, humanErbB ReceptorsIndolesosimertinibProtein Kinase InhibitorsPyrimidinescost‐effectiveness analysisEGFR‐mutated non‐small cell lung cancerhealth technology assessmentincremental cost‐effectiveness ratio (ICER)osimertinib

Identifiers

PMID42484063
PMCPMC13390182

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.