Abstract
BackgroundThe 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.MethodsA 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.ResultsOutcomes 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 and € 32343, respectively. Incremental cost-effectiveness ratios were € 23967 per QALY gained and € 17225 per LYG.ConclusionsPemetrexed 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/QALY threshold commonly accepted in Spain.
Highlights
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
Cost-effectiveness Results The base case cost-effectiveness analysis was run over a 3-year time-horizon, assuming no wastage, with best supportive care (BSC) provided during treatment, post treatment and at progression
The comparison of pemetrexed versus docetaxel resulted in an incremental cost-effectiveness ratio (ICER) of € 23967 per quality-adjusted life years (QALYs) and € 17225 per life years gained (LYG)
Summary
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. Lung cancer is the leading cause of cancer deaths worldwide [1]. It is the most common tumour in Spain, found mainly in men, and has the highest mortality. In Spain median survival rates of 40 weeks have been reported for patients with non-small cell lung cancer (NSCLC) [4] and 5-year survival is poor, estimated at only around 7% to 12% [2]. Docetaxel and pemetrexed, and the biologic drug erlotinib are currently approved for clinical use in the second-line setting, but a single-agent chemotherapy using docetaxel or pemetrexed is the recommended first option for these patients [5]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call