Healthcare outcomes: gemcitabine cost-effectiveness in the treatment of non-small cell lung cancer

The introduction of any new chemotherapy agent for non-small cell lung cancer (NSCLC) ought to be considered carefully in light of both costs and measurable benefits. Decision making is straightforward if a new treatment is relatively cheaper and more effective (i.e. introduce new therapy) or more expensive and less effective (i.e. reject new treatment) than standard therapies. However, if a treatment is more expensive and also more effective, or less expensive but also less effective, decision making becomes more complicated. An economic evaluation of the cost-effectiveness of gemcitabine in advanced NSCLC was performed as a case study. A comprehensive literature search for published economic evaluations of gemcitabine was carried out. Economic studies examining treatment for advanced NSCLC were limited to cost-minimization analyses and cost-effectiveness analyses. The analyses included primary economic studies, e.g. trials that included an integral economic evaluation, and secondary research, e.g. analyses based on published trial data and modeling. Overall, gemcitabine regimens proved cost-effective against standard therapies in this analysis. Prospective economic and quality-of-life analyses should be incorporated into study designs to help identify treatments that will maximize societal health benefits. (C) 2002 Published by Elsevier Science Ireland Ltd.