Cost-Effectiveness of Maintenance Pemetrexed in Patients with Advanced Nonsquamous-Cell Lung Cancer from the Perspective of the Swiss Health Care System

Jan 1, 2012, 00:00
10.1016/j.jval.2011.08.1737
https://www.valueinhealthjournal.com/article/S1098-3015(11)03322-5/fulltext
Title : Cost-Effectiveness of Maintenance Pemetrexed in Patients with Advanced Nonsquamous-Cell Lung Cancer from the Perspective of the Swiss Health Care System
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(11)03322-5&doi=10.1016/j.jval.2011.08.1737
First page : 65
Section Title : Economic Evaluation
Open access? : No
Section Order : 21

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.

Categories :
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Oncology
  • Respiratory-Related Disorders
  • Specific Diseases & Conditions
Tags :
  • best supportive care
  • cost-effectiveness
  • health economics
  • lung cancer
  • maintenance treatment
  • pemetrexed
Regions :
  • Africa
  • Middle East
  • Western Europe
ViH Article Tags :