Targeted Therapy in Advanced Non-Small Cell Lung Cancer (NSCLC): A Comparison of Erlotinib and Osimertinib within the Thai Healthcare System
Keywords:
Lung cancer, targeted therapy, public health policy, Thai health systemAbstract
This article aims to provide a policy analysis of targeted therapy utilization in advanced-stage non-small cell lung cancer (NSCLC) patients, comparing Erlotinib use under Thailand's Universal Coverage Scheme with Osimertinib use according to the National Comprehensive Cancer Network (NCCN) guidelines. The study employs a framework integrating clinical evidence, international practice standards, and healthcare resource allocation to propose policy considerations aligned with the Thai healthcare system context.
At present, lung cancer represents a significant public health challenge globally and in Thailand, particularly NSCLC, with the majority of patients diagnosed at advanced or metastatic stages. Medical advances have led to the identification of multiple genetic mutations, including epidermal growth factor receptor (EGFR) mutations, resulting in the development of targeted therapies in the EGFR tyrosine kinase inhibitor (EGFR-TKI) class. These therapies have demonstrated significant improvements in treatment efficacy and patient quality of life compared to conventional chemotherapy.
International clinical practice guidelines from NCCN recommend Osimertinib, a third-generation EGFR-TKI, as one of the first-line treatment options for patients with advanced NSCLC harboring EGFR mutations. However, within the Thai healthcare system context, health policy decisions must consider health economic value and resource availability within the healthcare delivery system. Consequently, Erlotinib, a first-generation EGFR-TKI, remains the first-line treatment option under Thailand's public health insurance system.
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