Cost-effectiveness of maintenance pemetrexed in patients with advanced nonsquamous-cell lung cancer from the perspective of the Swiss health care system.
Value Health
; 15(1): 65-71, 2012 Jan.
Article
em En
| MEDLINE
| ID: mdl-22264973
ABSTRACT
OBJECTIVES:
A recent randomized study showed switch maintenance with pemetrexed after nonpemetrexed-containing first-line chemotherapy in patients with advanced nonsmall-cell lung cancer to prolong overall survival by 2.8 months. We examined the cost-effectiveness of pemetrexed in this indication, from the perspective of the Swiss health care system, and assessed the influence of the costs of best supportive care (BSC) on overall cost-effectiveness.METHODS:
A Markov model was constructed based on the pemetrexed maintenance study, and the incremental cost-effectiveness ratio (ICER) of adding pemetrexed until disease progression was calculated as cost per quality-adjusted life-year gained. Uncertainties concerning the costs of BSC on the ICER were addressed.RESULTS:
The base case ICER for maintenance therapy with pemetrexed plus BSC compared to BSC alone was 106,202 per quality-adjusted life-year gained. Varying the costs for BSC had a marked effect. Assuming a reduction of the costs for BSC by 25% in the pemetrexed arm resulted in an ICER of 47,531 per quality-adjusted life-year, which is below predefined criteria for cost effectiveness in Switzerland.CONCLUSIONS:
Switch maintenance with pemetrexed in patients with advanced nonsquamous-cell lung cancer after standard first-line chemotherapy is not cost-effective. Uncertainties on the resource use and costs for BSC have a large influence on the cost-effectiveness calculation and should be reported in more detail.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Carcinoma Pulmonar de Células não Pequenas
/
Anos de Vida Ajustados por Qualidade de Vida
/
Glutamatos
/
Guanina
/
Neoplasias Pulmonares
/
Antimetabólitos Antineoplásicos
Tipo de estudo:
Clinical_trials
/
Evaluation_studies
/
Health_economic_evaluation
/
Prognostic_studies
Limite:
Humans
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article