Economic evaluation of docetaxel/gemcitabine versus docetaxel as frontline treatment of patients with advanced/metastatic non-small cell lung cancer in Greece

Abstract

Objectives: The combination of docetaxel/gemcitabine is an acceptable chemotherapy regimen for the treatment of non-small cell lung cancer. An economic evaluation is undertaken alongside a multi-centre randomized phase III trial, which compares docetaxel/gemcitabine combination with docetaxel monotherapy, in untreated patients with advanced/metastatic non-small cell lung cancer.

Methods: Trial resource utilisation data are combined with unit price data used to evaluate the cost of chemotherapy, concomitant medications, hospitalisations, diagnostic and laboratory tests and second-line chemotherapy. Treatment cost is combined with survival to estimate the incremental cost per-life-year-saved with the combination therapy versus monotherapy. To deal with uncertainty, stochastic analysis is used to plot cost-effectiveness acceptability curves.

Results: Median survival is 9.1 months (range 1-36.2) and 8.3 months (range 1-26.8) (p: 0.025) in the combination and monotherapy groups, respectively. The mean total treatment cost of patients with docetaxel is estimated at Euro5736 and with docetaxel/gemcitabine at Euro7417, a difference of Euro1542 (95%CI: Euro499-2561). The incremental cost per-life-year-saved of the combination therapy is euro9538 and the probability to be cost-effective is 91% at a threshold of Euro20,000, 97% at a threshold of Euro35,000 and 98% at a threshold of Euro50,000.

Conclusions: The data support that docetaxel/gemcitabine combination represents a cost-effective treatment option in relation to docetaxel monotherapy for patients with non-small cell lung cancer in the Greek NHS setting.