SynthesisCancer medicine2026
Pharmacoeconomic Analysis of Osimertinib Compared to Earlier-Generation EGFR Inhibitors in EGFR-Mutated NSCLC: A Systematic Review.
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.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
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.
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