Cost-utility analysis of chemotherapy in symptomatic advanced nonsmall cell lung cancer

被引:19
作者
Dooms, CA
Lievens, YN
Vansteenkiste, JF
机构
[1] Univ Hosp Gasthuisberg, Resp Oncol Unit, Dept Pulm, B-3000 Louvain, Belgium
[2] Univ Hosp Gasthuisberg, Resp Oncol Unit, Leuven Lung Canc Grp, B-3000 Louvain, Belgium
[3] Catholic Univ, Leuven Lung Canc Grp, Louvain, Belgium
[4] Catholic Univ, Dept Radiat Oncol, Louvain, Belgium
关键词
cisplatin-based chemotherapy; clinical benefit; cost-utility ratio; economic analysis; gemcitabine; nonsmall cell lung cancer;
D O I
10.1183/09031936.06.00102705
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
When using chemotherapy in patients with a short life expectancy, outcomes such as symptom improvement or clinical benefit receive increasing attention. Outcomes of subjective benefit to the patient can be rated as a utility in order to perform health economic analyses and comparisons with other treatment conditions. A cost-utility analysis has been performed alongside a prospective randomised clinical trial comparing single agent gemcitabine to cisplatin-based chemotherapy in symptomatic advanced nonsmall cell lung cancer patients. Global quality of life as well as resource utilisation data were collected during first-line chemotherapy for both treatment arms. Incremental costs, utilities and cost-utility ratio were calculated. Per patient, an incremental cost of Euro 1,522 was obtained for gemcitabine compared to cisplatin-vindesine, mainly as a consequence of the direct cost of the cytotoxic drugs. When combined with utilities, this resulted in an incremental cost-utility ratio for gemcitabine of Euro 13,836 per quality-adjusted life year gained. In conclusion, although the least expensive strategy is cisplatin-vindesine, the greater clinical benefit of gemcitabine, resulting in an acceptable incremental cost-utility ratio as compared with other healthcare interventions, balances its higher cost. The gains in subjective outcome achieved with palliative chemotherapy are critical from both a clinical and a health economic point of view.
引用
收藏
页码:895 / 901
页数:7
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