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Gentili N, Balzi W, Foca F, Danesi V, Altini M, Delmonte A, Bronte G, Crinò L, De Luigi N, Mariotti M, Verlicchi A, Burgio MA, Roncadori A, Burke T, Massa I. Healthcare Costs and Resource Utilisation of Italian Metastatic Non-Small Cell Lung Cancer Patients. Cancers (Basel) 2024; 16:592. [PMID: 38339345 PMCID: PMC10854909 DOI: 10.3390/cancers16030592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/12/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
This study evaluated the economic burden of metastatic non-small cell lung cancer patients before and after the availability of an immuno-oncology (IO) regimen as a first-line (1L) treatment. Patients from 2014 to 2020 were categorized according to mutational status into mutation-positive and negative/unknown groups, which were further divided into pre-1L IO and post-1L IO sub-groups depending on the availability of pembrolizumab monotherapy in 1L. Healthcare costs and HCRU for a 1L treatment and overall follow-up were reported as the mean total and per-month cost per patient by groups. Of 644 patients, 125were mutation-positive and 519 negative/unknown (229 and 290 in pre- and post-1L IO, respectively). The mean total per-patient cost in 1L was lower in pre- (EUR 7804) and post-1L IO (EUR 19,301) than the mutation-positive group (EUR 45,247), persisting throughout overall disease follow-up. However, this difference was less when analyzing monthly costs. Therapy costs were the primary driver in 1L, while hospitalization costs rose during follow-up. In both mutation-positive and post-IO 1L groups, the 1L costs represented a significant portion (70.1% and 66.3%, respectively) of the total costs in the overall follow-up. Pembrolizumab introduction increased expenses but improved survival. Higher hospitalisation and emergency room occupation rates during follow-up reflected worsening clinical conditions of the negative/unknown group than the mutation-positive population.
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Affiliation(s)
- Nicola Gentili
- Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (N.G.); (V.D.); (A.R.); (I.M.)
| | - William Balzi
- Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (N.G.); (V.D.); (A.R.); (I.M.)
| | - Flavia Foca
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy;
| | - Valentina Danesi
- Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (N.G.); (V.D.); (A.R.); (I.M.)
| | - Mattia Altini
- Healthcare Administration, Azienda Unità Sanitaria Locale della Romagna, 48121 Ravenna, Italy;
| | - Angelo Delmonte
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.); (G.B.); (L.C.); (M.M.); (A.V.); (M.A.B.)
| | - Giuseppe Bronte
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.); (G.B.); (L.C.); (M.M.); (A.V.); (M.A.B.)
| | - Lucio Crinò
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.); (G.B.); (L.C.); (M.M.); (A.V.); (M.A.B.)
| | - Nicoletta De Luigi
- Ospedale di Stato della Repubblica di San Marino, 47893 San Marino City, San Marino;
| | - Marita Mariotti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.); (G.B.); (L.C.); (M.M.); (A.V.); (M.A.B.)
| | - Alberto Verlicchi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.); (G.B.); (L.C.); (M.M.); (A.V.); (M.A.B.)
| | - Marco Angelo Burgio
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.); (G.B.); (L.C.); (M.M.); (A.V.); (M.A.B.)
| | - Andrea Roncadori
- Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (N.G.); (V.D.); (A.R.); (I.M.)
| | - Thomas Burke
- MSD Innovation & Development GmbH, 8004 Zurich, Switzerland
| | - Ilaria Massa
- Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (N.G.); (V.D.); (A.R.); (I.M.)
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Vergnenègre A, Chouaïd C. Review of economic analyses of treatment for non-small-cell lung cancer (NSCLC). Expert Rev Pharmacoecon Outcomes Res 2018; 18:519-528. [PMID: 29869900 DOI: 10.1080/14737167.2018.1485099] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION During the past few years, medical-economic evaluation of lung cancers (LCs) has become unavoidable. Total management costs have been rising constantly, with values almost doubling every 10 years. The financial impact will be even greater with the new molecules now marketed. The methodology for these studies conforms with international recommendations but must be adapted to the new stakes of LC management. AREAS COVERED This review provides an overview of the available literature concerning the economics of treating non-small-cell lung cancer (NSCLC). We first address the global costs of LCs. Detailed analyses were then computed for the different LC stages: localized, locally advanced and metastatic. For metastatic NSCLC, subsections are devoted to targeted therapies and immunotherapies. EXPERT COMMENTARY Drug costs are one of the major challenges of LC management. The multiplication of medical-economic analyses will assure better access to the marketing of these new and expensive therapeutic agents, but also to the selection of the best management strategy for these cancers.
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Affiliation(s)
- Alain Vergnenègre
- a Unité d'Oncologie Thoracique et Cutanée , Hôpital Dupuytren , Limoges , France
| | - Christos Chouaïd
- b Service de Pathologie Respiratoire , Centre Hospitalier Intercommunal de Créteil , Créteil , France
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Vergnenegre A, Massuti B, de Marinis F, Carcereny E, Felip E, Do P, Sanchez JM, Paz-Arez L, Chouaid C, Rosell R. Economic Analysis of First-Line Treatment with Erlotinib in an EGFR-Mutated Population with Advanced NSCLC. J Thorac Oncol 2016; 11:801-7. [PMID: 26899757 DOI: 10.1016/j.jtho.2016.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/29/2016] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The cost-effectiveness of first-line tyrosine kinase inhibitor therapy in epidermal growth factor receptor gene (EGFR)-mutated advanced-stage non-small cell lung cancer (NSCLC) is poorly documented. We therefore conducted a cost-effectiveness analysis of first-line treatment with erlotinib versus standard chemotherapy in European patients with advanced-stage EGFR-mutated NSCLC who were enrolled in the European Erlotinib versus Chemotherapy trial. METHODS The European Erlotinib versus Chemotherapy study was a multicenter, open-label, randomized phase III trial performed mainly in Spain, France, and Italy. We based our economic analysis on clinical data and data on resource consumption (drugs, drug administration, adverse events, and second-line treatments) collected during this trial. Utility values were derived from the literature. Incremental cost-effectiveness ratios were calculated for the first-line treatment phase and for the overall strategy from the perspective of the three participating countries. Sensitivity analyses were performed by selecting the main cost drivers. RESULTS Compared with standard first-line chemotherapy, the first-line treatment with erlotinib was cost saving (€7807, €17,311, and €19,364 for Spain, Italy and France, respectively) and yielded a gain of 0.117 quality-adjusted life-years. A probabilistic sensitivity analysis indicated that, given a willingness to pay at least €90,000 for 1 quality-adjusted life-year, the probability that a strategy of first-line erlotinib would be cost-effective was 100% in France, 100% in Italy, and 99.8% in Spain. CONCLUSION This economic analysis shows that first-line treatment with erlotinib, versus standard chemotherapy, is a dominant strategy for EGFR-mutated advanced-stage NSCLC in three European countries.
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Affiliation(s)
| | | | | | - Enric Carcereny
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Pascal Do
- Center for Cancer Disease François Baclesse, Caen, France
| | - Jose Miguel Sanchez
- Hospital Universitario 12 de Octubre, Madrid, Spain; M. D. Anderson, Madrid, Spain
| | - Luis Paz-Arez
- Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigaciones Biomedicas de Sevilla, Seville, Spain
| | | | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
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Coccia M. Path-breaking target therapies for lung cancer and a far-sighted health policy to support clinical and cost effectiveness. HEALTH POLICY AND TECHNOLOGY 2014. [DOI: 10.1016/j.hlpt.2013.09.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vergnenegre A, Borget I, Chouaid C. Treatment of lung cancer: will financial issues become a criterion of choice? Expert Rev Pharmacoecon Outcomes Res 2014; 13:273-5. [DOI: 10.1586/erp.13.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Shen C, Chien CR, Geynisman DM, Smieliauskas F, Shih YCT. A review of economic impact of targeted oral anticancer medications. Expert Rev Pharmacoecon Outcomes Res 2013; 14:45-69. [PMID: 24378038 DOI: 10.1586/14737167.2014.868310] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
There has been a rapid increase in the use of targeted oral anticancer medications (OAMs) in the past decade. As OAMs are often expensive, economic consideration play a significant role in the decision to prescribe, receive or cover them. This paper performs a systematic review of costs or budgetary impact of targeted OAMs to better understand their economic impact on the healthcare system, patients as well as payers. We present our review in a summary table that describes the method and main findings, take into account multiple factors, such as country, analytical approach, cost type, study perspective, timeframe, data sources, study population and care setting when we interpret the results from different papers, and discuss the policy and clinical implications. Our review raises a concern regarding the role of sponsorship on findings of economic analyses as the vast majority of pharmaceutical company-sponsored studies reported cost advantages toward the sponsor's drugs.
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Affiliation(s)
- Chan Shen
- Departments of Health Services Research and Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Vergnenègre A, Borget I, Chouaid C. Update on the treatment of non-small-cell lung cancer: focus on the cost-effectiveness of new agents. CLINICOECONOMICS AND OUTCOMES RESEARCH 2013; 5:137-41. [PMID: 23630426 PMCID: PMC3626258 DOI: 10.2147/ceor.s30670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The incidence of lung cancer and the cost of drug treatment have increased dramatically in the last decade. This article examines the costs of new target agents, such as tyrosine kinase inhibitors (TKIs) and anti-angiogenic drugs. Methods This study uses PubMed research to focus on the topics of lung cancer, economics, and new targeted therapies. Results The published papers only addressed TKIs and anti-angiogenic antibodies. For gefitinib, the results favored a clinical-based selection, despite the low number of studies. Erlotinib was studied in second line and as a maintenance treatment (with the studies reaching opposite conclusions in terms of cost-effectiveness). Economic analyses were not in favor of bevacizumab, but the studies on this topic were very heterogeneous. Conclusion The economic impact of a drug depends on the health care system organization. Future clinical trials must include economic analyses, particularly with TKIs in the first line.
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Affiliation(s)
- A Vergnenègre
- Service de Pathologie Respiratoire et d'Allergologie, CHU Dupuytren, Limoges, France ; Inserm, U707, Paris, France
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Getov I, Grigorov E, Naseva E, Kojnov K. Model Pharmacoeconomic Study on Iressa® (Gefitinib) as a First Line Treatment of Non-Small Cell Lung Cancer at Stage IIIB/IV in EGFR Mutation Positive Bulgarian Patients. BIOTECHNOL BIOTEC EQ 2013. [DOI: 10.5504/bbeq.2012.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Zeng X, Karnon J, Wang S, Wu B, Wan X, Peng L. The cost of treating advanced non-small cell lung cancer: estimates from the chinese experience. PLoS One 2012; 7:e48323. [PMID: 23118985 PMCID: PMC3485140 DOI: 10.1371/journal.pone.0048323] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 09/24/2012] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Because of the potentially significant economic burden of healthcare costs associated with many diseases, it is critical that regulatory and medical insurance organisations collect and utilise data on the cost-effectiveness of care provision to make rational policy decisions. However, little is known about healthcare costs in China. METHODOLOGY/PRINCIPAL FINDINGS Based on health expenditure data for 253 cases of advanced non-small cell lung cancer (NSCLC) registered at the Second Xiangya Hospital of Central South University in China between 2006 and 2010, the cost of care provision was analysed. The monthly and aggregate annual medical costs were estimated for patients who were in either a progression-free state (PFS) or a disease-progression state (DPS). Monthly healthcare costs accumulated during the terminal 3 months were collected separately. The mean cost of treatment for PFS and DPS patients over one year was approximately US$11,566 and $14,519, respectively. The monthly costs for all patients were higher initially than in the subsequent months (PFS: $2,490; DPS: $2,503). For PFS patients, healthcare expenditures stabilised after the 7th month, with a mean monthly medical expenditure of $82.49. For DPS patients, expenditures stabilised after the 9th month, and the mean expenditure during the 9th month was $307.9. Medical care costs in the three successive months prior to death were $3,754, $5,829 and $7,372, respectively. CONCLUSIONS/SIGNIFICANCE The economic evaluation of health care technologies is becoming ever more important in China, especially in disease areas for which new and expensive therapies are being introduced on a regular basis. This is first paper to present empirically estimated China-specific costs associated with the treatment of NSCLC. The cost estimates are presented in a format that is specifically intended to inform cost-effectiveness analyses of treatments for NSCLC, and hence, contribute to the more efficient allocation of limited healthcare resources in China.
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Affiliation(s)
- Xiaohui Zeng
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha Hunan, People’s Republic of China
- School of Pharmaceutical Sciences, Central South University, Changsha Hunan, PR China
| | - Jonathan Karnon
- Department of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Siying Wang
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha Hunan, People’s Republic of China
- School of Pharmaceutical Sciences, Central South University, Changsha Hunan, PR China
| | - Bin Wu
- Department of Pharmacy, School of Medicine, Shanghai Jiaotong University, Renji Hospital, Shanghai, People’s Republic of China
| | - Xiaomin Wan
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha Hunan, People’s Republic of China
- School of Pharmaceutical Sciences, Central South University, Changsha Hunan, PR China
| | - Liubao Peng
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha Hunan, People’s Republic of China
- School of Pharmaceutical Sciences, Central South University, Changsha Hunan, PR China
- * E-mail: .
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Le coût du traitement des cancers bronchopulmonaires non à petites cellules (CBNAPC). ONCOLOGIE 2012. [DOI: 10.1007/s10269-012-2158-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bongers ML, Coupé VMH, Jansma EP, Smit EF, Uyl-de Groot CA. Cost effectiveness of treatment with new agents in advanced non-small-cell lung cancer: a systematic review. PHARMACOECONOMICS 2012; 30:17-34. [PMID: 22201521 DOI: 10.2165/11595000-000000000-00000] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In past decades, studies focusing on new chemotherapeutic agents for patients with inoperable non-small-cell lung cancer have reported only modest gains in survival. These health gains are achieved at considerable cost, but economic evidence is lacking on superiority of one agent in terms of cost effectiveness. The objective of this systematic review was to assess fully published cost-effectiveness studies comparing the new agents docetaxel, paclitaxel, vinorelbine, gemcitabine and pemetrexed, and the targeted therapies erlotinib and gefitinib with one another. We performed systematic searches in the bibliographic databases PubMed, EMBASE and Health Economic Evaluations (HEED) [via the Cochrane Library] for fully published studies from the past 10 years. Studies were screened by two independent reviewers according to a priori inclusion criteria. The methodological quality of the included studies was evaluated by two independent reviewers using standardized assessment tools. A total of 222 potential studies were identified; 11 studies and six reviews were included. The methodological quality of the full economic evaluations was fairly good. Transparency in costs and resource use, details on statistical tests and sensitivity analysis were points for improvement. In first-line treatment, gemcitabine+cisplatin was cost effective compared with other platinum-based regimens (paclitaxel, docetaxel and vinorelbine). In one study, pemetrexed+cisplatin was cost effective compared with gemcitabine+cisplatin in patients with non-squamous-cell carcinoma. In second-line treatment, docetaxel was cost effective compared with best supportive care; erlotinib was cost effective compared with placebo; and docetaxel and pemetrexed were dominated by erlotinib. We found indications of superiority in terms of cost effectiveness for gemcitabine+cisplatin in a first-line setting, and for erlotinib in a second-line setting.
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Affiliation(s)
- Mathilda L Bongers
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, the Netherlands.
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Horgan A, Bradbury P, Amir E, Ng R, Douillard J, Kim E, Shepherd F, Leighl N. An economic analysis of the INTEREST trial, a randomized trial of docetaxel versus gefitinib as second-/third-line therapy in advanced non-small-cell lung cancer. Ann Oncol 2011; 22:1805-11. [DOI: 10.1093/annonc/mdq682] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Coate LE, Leighl NB. How affordable are targeted therapies in non-small cell lung cancer? Curr Treat Options Oncol 2011; 12:1-11. [PMID: 21267683 DOI: 10.1007/s11864-010-0137-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
As the treatment of non-small cell lung cancer (NSCLC) evolves to include more targeted therapies, costs of treatment have increased significantly. Advances in NSCLC treatment include longer survival duration, and in some cases, better progression-free survival and quality of life, and the potential for decreased toxicity. Through pharmacoeconomic analyses, payors seek to value the improvements in outcomes from novel therapies, and relate these improvements to their costs. In NSCLC, three categories of novel agents have been introduced into clinical practice: (1) agents targeting the epidermal growth factor receptor (EGFR); (2) agents targeting the vascular endothelial growth factor (VEGF) and (3) novel chemotherapy agents, specifically pemetrexed. Here we review published economic analyses for these agents in lung cancer, and their potential impact on treatment decisions.
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Affiliation(s)
- Linda E Coate
- Division of Medical Oncology, Princess Margaret Hospital, Toronto, ON, Canada
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Cost-Effectiveness of Second-Line Chemotherapy for Non-small Cell Lung Cancer: An Economic, Randomized, Prospective, Multicenter Phase III Trial Comparing Docetaxel and Pemetrexed: The GFPC 05-06 Study. J Thorac Oncol 2011; 6:161-8. [DOI: 10.1097/jto.0b013e318200f4c1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chouaid C, Atsou K, Hejblum G, Vergnenegre A. Economics of treatments for non-small cell lung cancer. PHARMACOECONOMICS 2009; 27:113-125. [PMID: 19254045 DOI: 10.2165/00019053-200927020-00003] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of this article is to review the economics of treatments for non-small cell lung cancer (NSCLC). We systematically analysed the cost effectiveness of treatments for the different stages of NSCLC, with particular emphasis on more recently approved agents. Numerous economic analyses in NSCLC have been conducted, with a variety of methods and in a number of countries. In patients with localized disease, adjuvant chemotherapy appears to have greater cost effectiveness than observation; however, there are few published data. In locally advanced disease, combined modalities (chemotherapy, surgery and/or radiotherapy) are probably cost effective, but high-quality economic analyses are lacking. In advanced NSCLC, third-generation chemotherapies used in the first-line setting can be administered with acceptable incremental cost effectiveness. In the second-line setting, new agents (docetaxel, pemetrexed and erlotinib) have acceptable cost effectiveness. The lack of cost-utility analyses for elderly patients and patients with a poor prognosis rules out firm conclusions. This review suggests that most therapies for NSCLC are cost effective when the patient has a good performance status, with an incremental cost-effectiveness ratio under USD 50,000 per life-year gained in the majority of cases.
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Chouaid C, Moser A, Coudray-Omnès C, Vergnenègre A. Conséquences économiques de l’erlotinib dans le traitement des cancers bronchopulmonaires non à petites cellules. Rev Mal Respir 2008; 25:1096-103. [DOI: 10.1016/s0761-8425(08)74979-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Linardou H, Dahabreh IJ, Kanaloupiti D, Siannis F, Bafaloukos D, Kosmidis P, Papadimitriou CA, Murray S. Assessment of somatic k-RAS mutations as a mechanism associated with resistance to EGFR-targeted agents: a systematic review and meta-analysis of studies in advanced non-small-cell lung cancer and metastatic colorectal cancer. Lancet Oncol 2008; 9:962-72. [PMID: 18804418 DOI: 10.1016/s1470-2045(08)70206-7] [Citation(s) in RCA: 578] [Impact Index Per Article: 36.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Helena Linardou
- 1st Department of Medical Oncology, Metropolitan Hospital, Athens, Greece
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Vergnenègre A, Atsou K, Molinier L, Chouaïd C. Les analyses économiques des cancers bronchopulmonaires (CBP). Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)82018-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Horgan A, Feld R, Leighl NB. Gefitinib: a consideration of cost. Expert Rev Pharmacoecon Outcomes Res 2008; 8:223-32. [PMID: 20528374 DOI: 10.1586/14737167.8.3.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cancer care is one of the most significant healthcare costs in the USA. The National Institute of Health (NIH) estimates healthcare spending at US$171.6 billion (2002), with lung cancer estimated as the diagnosis with the second highest cost. As additional lines of therapy and newer targeted agents are incorporated into the treatment of lung cancer, these costs will further increase. Gefitinib, an EGF receptor tyrosine kinase inhibitor, is well established in Asia for the treatment of advanced non-small-cell lung cancer. Although not widely available in the West, encouraging data have recently been reported from a large, global Phase III study of gefitinib in advanced non-small-cell lung cancer. This paper reviews the data supporting the use of gefitinib in the treatment of advanced non-small-cell-lung cancer and considers its potential economic impact, as well as quality-of-life outcomes, compared with cytotoxic chemotherapy.
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Affiliation(s)
- Anne Horgan
- Division of Medical Oncology/Hematology, Princess Margaret Hospital, University of Toronto, Canada
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