Abstract
7678 Background: Erlotinib was approved for funding as a systemic therapy treatment for 3rd line management of advanced NSCLC by the BC Cancer Agency (BCCA) in April 2004. BCCA patient outcome and cost data are routinely collected to verify the therapeutic effectiveness and cost-effectiveness of systemic treatment policies. Methods: This was a pragmatic retrospective analysis of all patients who received 3rd line erlotinib compared to a historical group treated with 2nd-line docetaxel then no further active treatment, both according to BCCA protocol. The primary end-point was cost-effectiveness, measured in terms of cost per-life-year-gained. Secondary end-points included: median overall survival (MOS); overall survival (OS) at 1 year; and comparison to phase III efficacy results. Data was retrieved from the Cancer Agency Information System (CAIS) and Systemic Therapy Data Warehouse. Life-years- gained were calculated from the area under the survival function curve. CEA took the BCCA perspective and costs included all direct drug costs for treatment of advanced disease. Sensitivity analyses included varying life expectancy across its 95% CI, cost to the extremes of ranges, and start date for length of survival: method 1. progression after 2nd line therapy or 3 weeks post last dose of chemotherapy for control group and start date of erlotinib for treatment group; method 2. last date of 2nd line therapy for both groups Results: 75 control and 70 erlotinib patients were included in the analysis. Results are presented in the table . The Incremental Cost-Effectiveness Ratio (ICER) was $28,516 per life-year-gained under method 1, and $17,632 under method 2. The erlotinib group had similar 1-year OS compared to literature (36 vs. 31%). Conclusions: Erlotinib appears to be cost-effective in terms of life-expectancy under a range of assumptions. No significant financial relationships to disclose. [Table: see text]
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