PMID- 34281538
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210723
IS  - 1478-7547 (Print)
IS  - 1478-7547 (Electronic)
IS  - 1478-7547 (Linking)
VI  - 19
IP  - 1
DP  - 2021 Jul 19
TI  - Cost-effectiveness analysis of neoadjuvant versus adjuvant chemotherapy for 
      cT2-4N0-1 non-small cell lung cancer patients during initial treatment phase.
PG  - 44
LID - 10.1186/s12962-021-00280-w [doi]
LID - 44
AB  - OBJECTIVE: The choice between neoadjuvant chemotherapy (NAC) and adjuvant 
      chemotherapy (AC) remains controversial in the treatment of non-small cell lung 
      cancer (NSCLC). There is no significant difference in NAC and AC's effectiveness. 
      We investigate the cost-effectiveness of NAC versus AC for NSCLC. METHOD: A 
      decision tree model was designed from a payer perspective to compare NAC and AC 
      treatments for NSCLC patients. Parameters included overall survival (OS), 
      surgical complications, chemotherapy adverse events (AEs), treatment initiation 
      probability, treatment time frame, treatment cost, and quality of life (QOL). 
      Sensitivity analyses were performed to characterize model uncertainty in the base 
      cases. RESULT: AC treatment strategy produced a cost saving of  yen3064.90 and 
      incremental quality-adjusted life-years (QALY) of 0.10 years per patient with the 
      same OS. NAC would be cost-effective at a  yen35,446/QALY threshold if the median OS 
      of NAC were 2.3 months more than AC. The model was robust enough to handle 
      variations to all input parameters except OS. In the probability sensitivity 
      analysis, AC remained dominant in 54.4% of simulations. CONCLUSION: The model 
      cost-effectiveness analysis indicates that with operable NSCLC, AC treatment is 
      more cost-effective to NAC. If NAC provides a longer survival advantage, this 
      treatment strategy may be cost-effective. The OS is the main factor that 
      influences cost-effectiveness and should be considered in therapeutic regimes.
CI  - (c) 2021. The Author(s).
FAU - Wu, Dongdong
AU  - Wu D
AD  - Department of Information, Daping Hospital, Army Medical University, Chongqing, 
      China.
FAU - Li, Juan
AU  - Li J
AD  - Department of Oncology, Daping Hospital, Army Medical University, Chongqing, 
      China.
FAU - Wang, Yubo
AU  - Wang Y
AD  - Respiratory Department, Daping Hospital, Army Medical University, Chongqing, 
      China.
FAU - Huang, Hao
AU  - Huang H
AD  - Department of Information, Daping Hospital, Army Medical University, Chongqing, 
      China.
FAU - Huang, Chunji
AU  - Huang C
AD  - Army Medical University, Gaotan Rock, Shapingba District, Chongqing, 400038, 
      China. hcjwyhws@163.com.
LA  - eng
PT  - Journal Article
DEP - 20210719
PL  - England
TA  - Cost Eff Resour Alloc
JT  - Cost effectiveness and resource allocation : C/E
JID - 101170476
PMC - PMC8287679
OTO - NOTNLM
OT  - Adjuvant chemotherapy
OT  - Cost-effectiveness
OT  - Neoadjuvant chemotherapy
OT  - Non-small cell lung cancer
COIS- The authors have no conflicts of interest to declare.
EDAT- 2021/07/21 06:00
MHDA- 2021/07/21 06:01
PMCR- 2021/07/19
CRDT- 2021/07/20 05:34
PHST- 2020/12/19 00:00 [received]
PHST- 2021/04/28 00:00 [accepted]
PHST- 2021/07/20 05:34 [entrez]
PHST- 2021/07/21 06:00 [pubmed]
PHST- 2021/07/21 06:01 [medline]
PHST- 2021/07/19 00:00 [pmc-release]
AID - 10.1186/s12962-021-00280-w [pii]
AID - 280 [pii]
AID - 10.1186/s12962-021-00280-w [doi]
PST - epublish
SO  - Cost Eff Resour Alloc. 2021 Jul 19;19(1):44. doi: 10.1186/s12962-021-00280-w.