Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2020; 8(20): 4793-4806
Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4793
Cost-effectiveness of lutetium (177Lu) oxodotreotide vs everolimus in gastroenteropancreatic neuroendocrine tumors in Norway and Sweden
Jayne Palmer, Oscar R Leeuwenkamp
Jayne Palmer, Ossian Health Economics and Communications, Basel 4051, Switzerland
Oscar R Leeuwenkamp, Advanced Accelerator Applications, Geneva 1204, Switzerland
Author contributions: Leeuwenkamp OR provided analysis support in conjunction with manuscript development; Palmer J prepared the first draft of the manuscript; Leeuwenkamp OR provided critical input and review to the first draft and all subsequent drafts of the manuscript. 
Institutional review board statement: No new clinical trial or patient level data were generated as part of this analysis. All data used in the analysis have been previously published, therefore institutional review board approval was not required.
Informed consent statement: No patients were directly involved in the analysis, therefore informed consent is not applicable.
Conflict-of-interest statement: Leeuwenkamp OR is a current employee of Advanced Accelerator Applications, which manufactures 177Lu-Dotatate. Palmer J is a current employee of Ossian Health Economics and Communications, which has received consulting fees from Advanced Accelerator Applications.
Data sharing statement: All input data used in the analysis are available from Leeuwenkamp OR upon reasonable request.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jayne Palmer, BSc, DPhil, Ossian Health Economics and Communications, Bäumleingasse 20, Basel 4051, Switzerland. smith-palmer@ossianconsulting.com
Received: July 8, 2020
Peer-review started: July 8, 2020
First decision: August 8, 2020
Revised: August 21, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: October 26, 2020
Processing time: 109 Days and 22.3 Hours
Core Tip

Core Tip: Peptide receptor radionuclide therapy with 177lutetium oxodotreotide (177Lu-Dotatate; Lutathera), which targets the overexpression of somatostatin receptors, particularly the somatostatin receptor type 2 expressed on the surface of tumor cells in some neuroendocrine tumors (NETs), is an efficacious new treatment approach for patients with gastroenteropancreatic NETs. To be adopted into routine clinical practice, new treatments should also be cost-effective as well as efficacious. Long-term health economic analyses suggest that in Sweden and Norway 177Lu-Dotate is likely to be cost-effective and associated with minimal budget impact relative to everolimus for the treatment of unresectable or metastatic progressive midgut or pancreatic NETs.