TY - JOUR

T1 - Cost-effectiveness analysis of pemetrexed versus docetaxel in the second-line treatment of non-small cell lung cancer in Spain

T2 - results for the non-squamous histology population

AU - Asukai, Yumi

AU - Valladares, Amparo

AU - Camps, Carlos

AU - Wood, Eifiona

AU - Taipale, Kaisa

AU - Arellano, Jorge

AU - Cassinello, Alejo

AU - Sacristán, José Antonio

AU - Dilla, Tatiana

PY - 2010/1/29

Y1 - 2010/1/29

N2 - BACKGROUND: The objective of this study was to conduct a cost-effectiveness evaluation of pemetrexed compared to docetaxel in the treatment of advanced or metastatic non-small cell lung cancer (NSCLC) for patients with predominantly non-squamous histology in the Spanish healthcare setting.METHODS: A Markov model was designed consisting of stable, responsive, progressive disease and death states. Patients could also experience adverse events as long as they received chemotherapy. Clinical inputs were based on an analysis of a phase III clinical trial that identified a statistically significant improvement in overall survival for non-squamous patients treated with pemetrexed compared with docetaxel. Costs were collected from the Spanish healthcare perspective.RESULTS: Outcomes of the model included total costs, total quality-adjusted life years (QALYs), total life years gained (LYG) and total progression-free survival (PFS). Mean survival was 1.03 years for the pemetrexed arm and 0.89 years in the docetaxel arm; QALYs were 0.52 compared to 0.42. Per-patient lifetime costs were 34677 euros and 32343 euros, respectively. Incremental cost-effectiveness ratios were 23967 euros per QALY gained and 17225 euros per LYG.CONCLUSIONS: Pemetrexed as a second-line treatment option for patients with a predominantly non-squamous histology in NSCLC is a cost-effective alternative to docetaxel according to the 30000 euros /QALY threshold commonly accepted in Spain.

AB - BACKGROUND: The objective of this study was to conduct a cost-effectiveness evaluation of pemetrexed compared to docetaxel in the treatment of advanced or metastatic non-small cell lung cancer (NSCLC) for patients with predominantly non-squamous histology in the Spanish healthcare setting.METHODS: A Markov model was designed consisting of stable, responsive, progressive disease and death states. Patients could also experience adverse events as long as they received chemotherapy. Clinical inputs were based on an analysis of a phase III clinical trial that identified a statistically significant improvement in overall survival for non-squamous patients treated with pemetrexed compared with docetaxel. Costs were collected from the Spanish healthcare perspective.RESULTS: Outcomes of the model included total costs, total quality-adjusted life years (QALYs), total life years gained (LYG) and total progression-free survival (PFS). Mean survival was 1.03 years for the pemetrexed arm and 0.89 years in the docetaxel arm; QALYs were 0.52 compared to 0.42. Per-patient lifetime costs were 34677 euros and 32343 euros, respectively. Incremental cost-effectiveness ratios were 23967 euros per QALY gained and 17225 euros per LYG.CONCLUSIONS: Pemetrexed as a second-line treatment option for patients with a predominantly non-squamous histology in NSCLC is a cost-effective alternative to docetaxel according to the 30000 euros /QALY threshold commonly accepted in Spain.

KW - Carcinoma/metabolism

KW - Carcinoma, Non-Small-Cell Lung/drug therapy

KW - Cell Line, Tumor

KW - Cost-Benefit Analysis

KW - Disease Progression

KW - Disease-Free Survival

KW - Docetaxel

KW - Female

KW - Glutamates/economics

KW - Guanine/analogs & derivatives

KW - Humans

KW - Lung Neoplasms/drug therapy

KW - Male

KW - Markov Chains

KW - Pemetrexed

KW - Quality of Life

KW - Quality-Adjusted Life Years

KW - Spain

KW - Taxoids/economics

KW - Treatment Outcome

U2 - 10.1186/1471-2407-10-26

DO - 10.1186/1471-2407-10-26

M3 - Article

C2 - 20113499

VL - 10

SP - 26

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

ER -