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Cost Effectiveness of Treatment with New Agents in Advanced Non-Small-Cell Lung Cancer

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  • Mathilda Bongers
  • Veerle Coupé
  • Elise Jansma
  • Egbert Smit
  • Carin Groot

Abstract

In past decades, studies focusing on new chemotherapeutic agents for patients with inoperable non-small-cell lung cancer have reported only modest gains in survival. These health gains are achieved at considerable cost, but economic evidence is lacking on superiority of one agent in terms of cost effectiveness. The objective of this systematic review was to assess fully published cost-effectiveness studies comparing the new agents docetaxel, paclitaxel, vinorelbine, gemcitabine and pemetrexed, and the targeted therapies erlotinib and gefitinib with one another. We performed systematic searches in the bibliographic databases PubMed, EMBASE and Health Economic Evaluations (HEED) [via the Cochrane Library] for fully published studies from the past 10 years. Studies were screened by two independent reviewers according to a priori inclusion criteria. The methodological quality of the included studies was evaluated by two independent reviewers using standardized assessment tools. A total of 222 potential studies were identified; 11 studies and six reviews were included. The methodological quality of the full economic evaluations was fairly good. Transparency in costs and resource use, details on statistical tests and sensitivity analysis were points for improvement. In first-line treatment, gemcitabine+cisplatin was cost effective compared with other platinum-based regimens (paclitaxel, docetaxel and vinorelbine). In one study, pemetrexed+ cisplatin was cost effective compared with gemcitabine+cisplatin in patients with non-squamous-cell carcinoma. In second-line treatment, docetaxel was cost effective compared with best supportive care; erlotinib was cost effective compared with placebo; and docetaxel and pemetrexed were dominated by erlotinib. We found indications of superiority in terms of cost effectiveness for gemcitabine+cisplatin in a first-line setting, and for erlotinib in a second-line setting. Copyright Adis Data Information BV 2012

Suggested Citation

  • Mathilda Bongers & Veerle Coupé & Elise Jansma & Egbert Smit & Carin Groot, 2012. "Cost Effectiveness of Treatment with New Agents in Advanced Non-Small-Cell Lung Cancer," PharmacoEconomics, Springer, vol. 30(1), pages 17-34, January.
    • Handle: RePEc:spr:pharme:v:30:y:2012:i:1:p:17-34
    DOI: 10.2165/11595000-000000000-00000
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    References listed on IDEAS

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    1. Julie Sturza, 2010. "A Review and Meta-Analysis of Utility Values for Lung Cancer," Medical Decision Making, , vol. 30(6), pages 685-693, November.
    2. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    3. Rob Anderson, 2010. "Systematic reviews of economic evaluations: utility or futility?," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 350-364, March.
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    Cited by:

    1. Cuc Thi Thu Nguyen & Fabio Petrelli & Stefania Scuri & Binh Thanh Nguyen & Iolanda Grappasonni, 2019. "A systematic review of pharmacoeconomic evaluations of erlotinib in the first-line treatment of advanced non-small cell lung cancer," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 763-777, July.
    2. Siying Wang & Liubao Peng & Jianhe Li & Xiaohui Zeng & Lihui Ouyang & Chongqing Tan & Qiong Lu, 2013. "A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-9, March.

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