PMID- 16650499
OWN - NLM
STAT- MEDLINE
DCOM- 20061025
LR  - 20221207
IS  - 0169-5002 (Print)
IS  - 0169-5002 (Linking)
VI  - 52
IP  - 3
DP  - 2006 Jun
TI  - Cost-minimization analysis for Portugal of five doublet chemotherapy regimens 
      from two phase III trials in the treatment of advanced non-small cell lung 
      cancer.
PG  - 365-71
AB  - OBJECTIVES: Economic evaluations of chemotherapy regimens for stage IIIB or IV 
      non-small cell lung cancer (NSCLC) have been conducted for many European 
      countries, but not for Portugal. This study evaluates the total health care costs 
      of five commonly used doublet regimens with similar efficacy results. METHODS: 
      Using the methodology reported by Schiller [Schiller JH, Tilden D, Aristides M, 
      Lees M, Kielhorn A, Maniadakis N, et al. Restropective cost analysis of 
      gemcitabine in combination with cisplatin in non-small cell lung cancer compared 
      to other combination therapies in Europe. Lung Cancer 2004;43:101-12], we 
      conducted a cost-minimization analysis to compare vinorelbine-cisplatin 
      (Vin/Cis), gemcitabine-cisplatin (Gem/Cis), paclitaxel-carboplatin (Pac/Carb), 
      docetaxel-cisplatin (Doc/Cis), and paclitaxel-cisplatin (Pac/Cis). The 
      perspective was that of the Portuguese National Health Service and included only 
      direct medical costs (reimbursed costs plus co-payments): chemotherapy 
      acquisition, chemotherapy administration, hospitalizations due to adverse events, 
      and other medical resources. Unit costs were drawn from official sources 
      (Diagnosis Related Groups and retail/hospital costs) (2003 value [Diagnosis 
      Related Groups (DRG) published at Diario da Republica; 2003]). Resource use was 
      estimated from two multicenter randomized phase III trials [Comella P, Frasci G, 
      Panza N, Manzione L, De Cataldis G, Cioffi R, et al. Randomized trial comparing 
      cisplatin, gemcitabine, and vinorelbine with either cisplatin and gemcitabine or 
      cisplatin and vinorelbine in advanced non-small-cell lung cancer: interim 
      analysis of a phase III trial of the Southern Italy Cooperative Oncology Group. J 
      Clin Oncol 2000;18:1451-7; Schiller JH, Harrington D, Belani CP, Langer C, 
      Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced 
      non-small-cell lung cancer. N Engl J Med 2002;346:92-8]. A time horizon of a full 
      course of therapy was adopted. One-way sensitivity analyses were performed. 
      RESULTS: The least and the most costly chemotherapy regimens were Gem/Cis and 
      Pac/Carb, respectively. Total mean cost per patient was estimated at euro7083 for 
      Gem/Cis and euro10,008 for Pac/Carb, a mean cost savings of euro2925 per patient 
      for Gem/Cis. The differences were mainly due to the higher chemotherapy 
      acquisition costs of Pac/Carb than for Gem/Cis. Gem/Cis was less costly in all 
      sensitivity analyses except when 100% inpatient chemotherapy administration was 
      assumed. CONCLUSION: Gem/Cis should be considered as a cost-saving alternative to 
      the other four regimens in treating NSCLC patients in Portugal.
FAU - Pimentel, F L
AU  - Pimentel FL
AD  - Hospital Sao Sebastiao, Oncology Department, R. Dr. Candido Pinho, 4520-211 Santa 
      Maria da Feira, Portugal. fpimentel@cs.ua.pt
FAU - Bhalla, S
AU  - Bhalla S
FAU - Laranjeira, L
AU  - Laranjeira L
FAU - Guerreiro, M
AU  - Guerreiro M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20060502
PL  - Ireland
TA  - Lung Cancer
JT  - Lung cancer (Amsterdam, Netherlands)
JID - 8800805
RN  - 0 (Taxoids)
RN  - 0W860991D6 (Deoxycytidine)
RN  - 15H5577CQD (Docetaxel)
RN  - BG3F62OND5 (Carboplatin)
RN  - P88XT4IS4D (Paclitaxel)
RN  - Q20Q21Q62J (Cisplatin)
RN  - 0 (Gemcitabine)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*economics
MH  - Carboplatin/administration & dosage/economics
MH  - Carcinoma, Non-Small-Cell Lung/drug therapy/*economics
MH  - Cisplatin/administration & dosage/economics
MH  - Clinical Trials, Phase III as Topic
MH  - Costs and Cost Analysis
MH  - Deoxycytidine/administration & dosage/analogs & derivatives/economics
MH  - Docetaxel
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/drug therapy/*economics
MH  - Male
MH  - National Health Programs/economics
MH  - Paclitaxel/administration & dosage/economics
MH  - Portugal
MH  - Taxoids/administration & dosage/economics
MH  - Gemcitabine
EDAT- 2006/05/03 09:00
MHDA- 2006/10/26 09:00
CRDT- 2006/05/03 09:00
PHST- 2006/01/23 00:00 [received]
PHST- 2006/03/08 00:00 [revised]
PHST- 2006/03/10 00:00 [accepted]
PHST- 2006/05/03 09:00 [pubmed]
PHST- 2006/10/26 09:00 [medline]
PHST- 2006/05/03 09:00 [entrez]
AID - S0169-5002(06)00135-8 [pii]
AID - 10.1016/j.lungcan.2006.03.005 [doi]
PST - ppublish
SO  - Lung Cancer. 2006 Jun;52(3):365-71. doi: 10.1016/j.lungcan.2006.03.005. Epub 2006 
      May 2.