Abstract
BackgroundFor stage IV lung cancer patients receiving add-on Viscum album L. (VA) treatment an improved overall survival was detected. Information regarding cost-effectiveness (CE) for comparisons between chemotherapy (CTx) and CTx plus additive VA in stage IV lung cancer treatment is limited. The present study assessed the costs and cost-effectiveness of CTx plus VA (V) compared to CTx alone (C) for stage IV non-small cell lung cancer (NSCLC) patients treatment in a hospital in Germany.MethodsIn the observational real-world data study, data from the Network Oncology clinical registry were utilized. Enrolled stage IV lung cancer patients received the respective therapy (C or V) in a certified German Cancer Center. Cost and cost-effectiveness analyses from the hospital’s perspective were investigated on the basis of overall survival (OS) and routine financial controlling data. In addition, the incremental cost-effectiveness ratio (ICER) was calculated. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis.Results118 patients (C: n = 86, V: n = 32) were included in the analysis, mean age 63.8 years, the proportion of male patients was 55.1%. Adjusted hospital’s total mean costs for patients from the C and V group were €16,289, 95%CI: 13,834€-18,744€ (over an adjusted mean OS time of 13.4 months) and €17,992, 95%CI: 13,658–22,326 (over an adjusted mean OS time of 19.1 months), respectively. The costs per additional OS year gained (ICER) with the V-therapy compared to C therapy were €3,586.ConclusionThe findings of the present study suggest that the combined use of chemotherapy and VA was clinically effective and comparably cost-effective to chemotherapy alone in our analysed patient sample from the hospital’s perspective. Further randomized and prospective cost-effectiveness studies are necessary to complement our findings.
Highlights
Integrative oncology (IO) has been increasingly established and acknowledged for the improvement of health-related quality of life during the last decades in international academic and public cancer centres [1, 2]
CEA of combined CTx and Viscum album L. (VA) compared to CTx in stage IV non-small cell lung cancer (NSCLC)
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Summary
Integrative oncology (IO) has been increasingly established and acknowledged for the improvement of health-related quality of life during the last decades in international academic and public cancer centres [1, 2]. Complementary mistletoe extracts (Viscum album Loranthaceae, VA) which are applied within IO concepts improve the health-related quality of life (HRQL) of oncological patients [4, 5]. IO concepts aim to be accepted in the future as routinely applied health care elements as they contribute to clinical effectiveness by helping people with cancer to maintain their HRQL, to maintain dosing and to avoid interruption of standard oncological treatment. Information regarding cost-effectiveness (CE) for comparisons between chemotherapy (CTx) and CTx plus additive VA in stage IV lung cancer treatment is limited. The present study assessed the costs and cost-effectiveness of CTx plus VA (V) compared to CTx alone (C) for stage IV non-small cell lung cancer (NSCLC) patients treatment in a hospital in Germany
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