Cost-effectiveness of bevacizumab-based therapy versus cisplatin plus pemetrexed for the first-line treatment of advanced non-squamous NSCLC in Korea and Taiwan.

Abstract

AIMS:

The aim of this analysis is to investigate the mean incremental costs and life expectancy associated with two first-line treatments for advanced non-squamous non-small cell lung cancer (NSCLC) in Korea and Taiwan; bevacizumab plus cisplatin and gemcitabine (BevCG) and cisplatin plus pemetrexed (CP).

METHODS:

A health economic (area under curve) model with three health states was developed to assess health outcomes (life-years gained [LYG]), direct costs, and incremental cost-effectiveness ratio (ICER). Progression-free survival (PFS) and overall survival (OS) were derived from randomized clinical trials and used in an indirect comparison in order to estimate their cost effectiveness. A life-time horizon was used. Costs and outcomes were discounted yearly by 5% in Korea and by 3% in Taiwan.

RESULTS:

The incremental LYG for the BevCG patients compared with patients treated with CP were 1.10 (13.2 months) in Korea and 1.19 (14.3 months) in Taiwan. The incremental costs were 37,439,968 ($ 33,322) in Korea and NT$ 1,910,615 ($ 64,541) in Taiwan. The incremental cost-effectiveness ratio was 34,064,835 ($ 30,318) in Korea and NT$ 1,607,960 ($ 54,317) in Taiwan. The inputs tested in one-way sensitivity analyses had very little impact on the overall cost effectiveness.

CONCLUSION:

This analysis shows that BevCG is more costly but is also associated with additional life-years in Korea and Taiwan. The ICER per LYG suggests that BevCG is a cost-effective therapy when compared to CP for patients with advanced NSCLC in Korea and Taiwan.

• Authors: Myung-Ju Ahn, Chun-Ming Tsai, Te-Chun Hsia, Elaine Wright, John Wen-Cheng Chang, Heung Tae Kim, Joo-Hang Kim, Jin Hyoung Kang, Sang-We Kim, Eun-Jin Bae, Mijeong Kang, Johanna Lister, Stefan Walzer
• Journal: Asia-Pacific journal of clinical oncology (Asia Pac J Clin Oncol) Vol. 7 Suppl 2 Pg. 22-33 (Jun 2011) ISSN: 1743-7563 [Electronic] Australia
• PMID: 21585705 (Publication Type: Journal Article)
• Copyright: © 2011 Blackwell Publishing Asia Pty Ltd.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Glutamates
• Pemetrexed
• Bevacizumab
• Guanine
• Cisplatin

Topics

• Adult
• Aged
• Antibodies, Monoclonal (administration & dosage, economics, therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antineoplastic Combined Chemotherapy Protocols (economics, therapeutic use)
• Bevacizumab
• Carcinoma, Non-Small-Cell Lung (drug therapy, economics)
• Cisplatin (administration & dosage)
• Cost-Benefit Analysis
• Disease-Free Survival
• Female
• Glutamates (administration & dosage)
• Guanine (administration & dosage, analogs & derivatives)
• Humans
• Korea
• Lung Neoplasms (drug therapy, economics)
• Male
• Middle Aged
• Pemetrexed
• Survival Analysis
• Taiwan