{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:20:16Z","timestamp":1785417616860,"version":"3.56.0"},"reference-count":39,"publisher":"The Journal of Health Economics and Outcomes Research","issue":"1","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["jheor.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent clinical trials have demonstrated improved efficacy of combination regimens, including amivantamab plus lazertinib and osimertinib plus platinum-based chemotherapy, compared with standard therapy in patients with epidermal growth factor receptor (EGFR)\u2013mutated non-small cell lung cancer (NSCLC). As these regimens enter routine clinical use, understanding the economic implications of treatment-related adverse event (AE) management, including proactive therapy management (PTM), is important.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objectives\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate and compare grade 3 or 4 AE management costs associated with first-line amivantamab (intravenous [IV] or subcutaneous [SC]) plus lazertinib and osimertinib plus platinum-based chemotherapy in patients with EGFR-mutated locally advanced or metastatic NSCLC from a US Commercial and Medicare Advantage payer perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive cost modeling analysis used grade 3\/4 AE incidence data from pivotal clinical trials of amivantamab (IV and SC) plus lazertinib and osimertinib plus platinum-based chemotherapy. AEs occurring in \u22655% of patients or deemed clinically significant were included. PTM strategies for dermatologic events, venous thromboembolism, and infusion-related reactions were modeled for amivantamab-based regimens using guideline-concordant practices and clinical trial evidence. As a conservative assumption, PTM for osimertinib plus platinum-based chemotherapy was not included. AE management costs were derived from national inpatient and physician fee schedules and inflated to 2025 US dollars. Total per-patient AE management and PTM costs were estimated for each treatment regimen. Scenario analyses evaluated expanded PTM assumptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across both payer perspectives, total AE management costs were estimated to be lower for amivantamab-based regimens than for osimertinib plus platinum-based chemotherapy. Under the Commercial perspective, modeled AE management costs were $2345 for amivantamab (SC) plus lazertinib, $4321 for amivantamab (IV) plus lazertinib, and $8497 for osimertinib plus platinum-based chemotherapy. Corresponding Medicare Advantage estimates were $1166, $2425, and $4185, respectively. Inclusion of PTM costs did not alter the relative cost ranking calculated and findings were consistent across scenario analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Results from this descriptive cross-trial analysis indicated that total AE management costs were consistently estimated to be lower in patients receiving amivantamab (SC or IV) plus lazertinib compared with osimertinib plus platinum-based chemotherapy across both a Commercial and Medicare Advantage payer perspective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.36469\/001c.161356","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:02:10Z","timestamp":1779123730000},"update-policy":"https:\/\/doi.org\/10.36469\/00001","source":"Crossref","is-referenced-by-count":0,"title":["Estimated Cost of Adverse Event Management in Treatment Na\u00efve Non-small Cell Lung Cancer Patients with Common EGFR Mutations Treated with Amivantamab Plus Lazertinib and Osimertinib Plus Chemotherapy"],"prefix":"10.36469","volume":"13","author":[{"given":"Alexander","family":"Spira","sequence":"first","affiliation":[{"name":"Virginia Cancer Specialists Research Institute, Fairfax, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratyusha","family":"Vadagam","sequence":"additional","affiliation":[{"name":"Johnson & Johnson, Horsham, Pennsylvania","department":["Real-World Value & Evidence"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Lin","sequence":"additional","affiliation":[{"name":"Johnson & Johnson, Horsham, Pennsylvania","department":["Real-World Value & Evidence"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Longfield","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03qd7mz70","id-type":"ROR","asserted-by":"publisher"}],"name":"Johnson & Johnson, Horsham, Pennsylvania","department":["Real-World Value and Evidence"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6521-6967","authenticated-orcid":false,"given":"Robert","family":"Musci","sequence":"additional","affiliation":[{"name":"Evidera, Inc., San Francisco, California","department":["Health Economics and Market Access"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Wang","sequence":"additional","affiliation":[{"name":"Evidera, Inc., Evidera, Inc., San Francisco, California","department":["Health Economics and Market Access"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Zou","sequence":"additional","affiliation":[{"name":"Evidera, Inc., Evidera, Inc., San Francisco, California","department":["Health Economics and Market Access"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22273","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1001\/jamainternmed.2014.5841","article-title":"Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis","volume":"175","author":"M. Viswanathan","year":"2015","journal-title":"JAMA Intern Med"},{"issue":"7","key":"ref2","doi-asserted-by":"publisher","first-page":"oyaf194","DOI":"10.1093\/oncolo\/oyaf194","article-title":"Mitigation and management of adverse events associated with amivantamab therapy","volume":"30","author":"N. Florez","year":"2025","journal-title":"Oncologist"},{"key":"ref3","article-title":"Rybrevant (amivantamab-vmjw) Prescribing Information","year":"2025"},{"issue":"16","key":"ref4","doi-asserted-by":"publisher","first-page":"1486","DOI":"10.1056\/NEJMoa2403614","article-title":"Amivantamab plus lazertinib in previously untreated EGFR-mutated advanced NSCLC","volume":"391","author":"B.C. Cho","year":"2024","journal-title":"N Engl J Med"},{"key":"ref5","article-title":"Subcutaneous amivantamab and lazertinib as first-line treatment in patients with EGFR-mutated advanced non-small cell lung cancer (NSCLC): interim results from the phase 2 PALOMA-2 Study","author":"S. M. Lim"},{"issue":"30","key":"ref6","doi-asserted-by":"publisher","first-page":"3593","DOI":"10.1200\/jco.24.01001","article-title":"Subcutaneous versus intravenous amivantamab, both in combination with lazertinib, in refractory epidermal growth factor receptor-mutated non-small cell lung cancer: primary results from the phase III PALOMA-3 study","volume":"42","author":"N. B. Leighl","year":"2024","journal-title":"J Clin Oncol"},{"key":"ref7","article-title":"Tagrisso (osimertinib) Prescribing information","year":"2024"},{"issue":"21","key":"ref8","doi-asserted-by":"publisher","first-page":"1935","DOI":"10.1056\/NEJMoa2306434","article-title":"Osimertinib with or without chemotherapy in EGFR-mutated advanced NSCLC","volume":"389","author":"D. Planchard","year":"2023","journal-title":"N Engl J Med"},{"key":"ref9","article-title":"Tarceva (erlotinib) Prescribing Information","year":"2016"},{"key":"ref10","article-title":"Iressa (gefitinib) Prescribing information","year":"2019"},{"key":"ref11","article-title":"What is lung cancer?","author":"American Cancer Society","year":"2024"},{"key":"ref12","article-title":"Gilotrif (afatinib) Prescribing information","year":"2018"},{"key":"ref13","article-title":"Vizimpro (dacomitinib) Prescribing Information","year":"2018"},{"issue":"9","key":"ref14","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1016\/j.jtho.2022.05.008","article-title":"Addition of bevacizumab to erlotinib as first-line treatment of patients with EGFR-mutated advanced nonsquamous NSCLC: the BEVERLY Multicenter Randomized Phase 3 Trial","volume":"17","author":"M. C. Piccirillo","year":"2022","journal-title":"J Thorac Oncol"},{"issue":"12","key":"ref15","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1016\/S1470-2045(19)30634-5","article-title":"Ramucirumab plus erlotinib in patients with untreated, EGFR-mutated, advanced non-small-cell lung cancer (RELAY): a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"20","author":"K. Nakagawa","year":"2019","journal-title":"Lancet Oncol"},{"issue":"10","key":"ref16","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1016\/j.jtho.2025.07.117","article-title":"Enhanced versus standard dermatologic management with amivantamab-lazertinib in EGFR-mutated advanced NSCLC: the COCOON Global Randomized Controlled Trial","volume":"20","author":"B.C. Cho","year":"2025","journal-title":"J Thorac Oncol"},{"issue":"17","key":"ref17","doi-asserted-by":"publisher","first-page":"1681","DOI":"10.1056\/NEJMoa2503001","article-title":"Overall survival with amivantamab-lazertinib in EGFR-mutated advanced NSCLC","volume":"393","author":"J. C. Yang","year":"2025","journal-title":"N Engl J Med"},{"key":"ref18","doi-asserted-by":"crossref","DOI":"10.1016\/j.annonc.2024.08.1326","article-title":"Preventing infusion-related reactions with intravenous amivantamab: updated results from SKIPPirr, a phase 2 study","author":"L. Paz-Ares","year":"2024"},{"key":"ref19","article-title":"Cost of adverse event management in first-line EGFR-mutated advanced NSCLC treated with osimertinib + platinum-pemetrexed versus amivantamab + lazertinib","author":"G. Lopes","year":"2025"},{"key":"ref20","doi-asserted-by":"crossref","DOI":"10.1016\/S1556-0864(25)00205-9","article-title":"Preventing moderate to severe dermatologic adverse events in first-line EGFR-mutant advanced NSCLC treated with amivantamab plus lazertinib. early success of the COCOON Trial","author":"N. Girard","year":"2025"},{"key":"ref21","article-title":"HCUPnet inpatient stays, national statistics by Clinical Classification Software Refined (CCSR), principal diagnosis. All payer 2020 cost","author":"AHRQ"},{"issue":"1","key":"ref22","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.21871","article-title":"Cancer statistics, 2025","volume":"75","author":"R. L. Siegel","year":"2025","journal-title":"CA Cancer J Clin"},{"key":"ref23","article-title":"Consumer Price Index for All Urban Consumers (CPI-U): Medical Care","author":"US Bureau of Labor Statistics"},{"key":"ref24","article-title":"Medicare acute inpatient PPS. FY 2025 IPPS final rule home page: DRG payment per stay","author":"Centers for Medicare & Medicaid Services","year":"2025"},{"key":"ref25","article-title":"Medical Fees Directory 2025 - eBook. Usual, Customary, and Reasonable (UCR) Fees","author":"Practice Management Information Corporation (PMIC)","year":"2025"},{"key":"ref26","article-title":"Physician fee schedule look-up tool. National payment amount FY 2025","author":"Centers for Medicare & Medicaid Services","year":"2025"},{"key":"ref27","article-title":"Merative Micromedex\u00ae. RED BOOK\u00ae Online"},{"key":"ref28","article-title":"Medicare payment allowance limits for Medicare Part B Drugs. Q1-Effective January 1, 2025 through March 31, 2025","author":"Centers for Medicare & Medicaid Services","year":"2025"},{"key":"ref29","article-title":"Chemotherapy for non-small cell lung cancer","author":"American Cancer Society","year":"2024"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"806728","DOI":"10.3389\/fphar.2022.806728","article-title":"Quantitative comparison of the efficacies and safety profiles of three first-line non-platinum chemotherapy regimens for advanced non-small cell lung cancer","volume":"13","author":"Q. Y. Yang","year":"2022","journal-title":"Front Pharmacol"},{"issue":"10","key":"ref31","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.6004\/jnccn.2013.0148","article-title":"Myeloid growth factors","volume":"11","author":"J. Crawford","year":"2013","journal-title":"J Natl Compr Canc Netw"},{"issue":"1","key":"ref32","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1200\/jop.2014.001492","article-title":"Risk and Consequences of chemotherapy-induced febrile neutropenia in patients with metastatic solid tumors","volume":"11","author":"D. Weycker","year":"2015","journal-title":"J Oncol Pract"},{"issue":"3 suppl","key":"ref33","doi-asserted-by":"publisher","first-page":"S317","DOI":"10.1016\/j.jtho.2021.01.485","article-title":"Estimating the Total US incidence of advanced\/metastatic non-small cell lung (NSCLC) including recurrent disease","volume":"16","author":"C. Huntzinger","year":"2021","journal-title":"J Thorac Oncol"},{"issue":"1","key":"ref34","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.jval.2010.10.006","article-title":"Lung cancer treatment costs, including patient responsibility, by disease stage and treatment modality, 1992 to 2003","volume":"14","author":"L. E. Cipriano","year":"2011","journal-title":"Value Health"},{"issue":"3","key":"ref35","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1038\/nrc2088","article-title":"Epidermal growth factor receptor mutations in lung cancer","volume":"7","author":"S. V. Sharma","year":"2007","journal-title":"Nat Rev Cancer"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.semcancer.2019.09.015","article-title":"Rare epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer","volume":"61","author":"P. T. Harrison","year":"2020","journal-title":"Semin Cancer Biol"},{"issue":"28 suppl","key":"ref37","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1200\/JCO.2020.39.28_suppl.298","article-title":"Real-world EGFR testing patterns among US patients with NSCLC","volume":"39","author":"J. Vanderpoel","year":"2021","journal-title":"J Clin Oncol"},{"key":"ref38","article-title":"NCCN Guidelines: Non-Small Cell Lung Cancer v3.2025","author":"National Comprehensive Cancer Network (NCCN)","year":"2025"},{"key":"ref39","first-page":"27","article-title":"Estimating the costs of adverse events in economic models: is there a \"right\" approach?","author":"W. Wong","year":"2019","journal-title":"Value & Outcomes Spotlight"}],"container-title":["Journal of Health Economics and Outcomes Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jheor.org\/article\/161356-estimated-cost-of-adverse-event-management-in-treatment-naive-non-small-cell-lung-cancer-patients-with-common-egfr-mutations-treated-with-amivantamab","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:31:32Z","timestamp":1779381092000},"score":1,"resource":{"primary":{"URL":"https:\/\/jheor.org\/article\/161356-estimated-cost-of-adverse-event-management-in-treatment-naive-non-small-cell-lung-cancer-patients-with-common-egfr-mutations-treated-with-amivantamab"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.36469\/001c.161356","relation":{},"ISSN":["2327-2236"],"issn-type":[{"value":"2327-2236","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]}}}