An economic analysis of dose dense weekly paclitaxel plus carboplatin versus every-3-week paclitaxel plus carboplatin in the treatment of advanced ovarian cancer

作者：Dalton Heather J; Yu Xinhua; Hu Lilian; Kapp Daniel S; Benjamin Ivor; Monk Bradley J; Chan John K^*

来源：Gynecologic Oncology, 2012, 124(2): 199-204.

DOI：10.1016/j.ygyno.2011.09.028

• Ovary
• Chemotherapy
• Economic analysis

Objective. Compared with every-3-week paclitaxel (q3T) plus carboplatin, dose-dense weekly paclitaxel (ddT) plus carboplatin improved the survival of ovarian cancer patients. We performed a cost analysis comparing these two regimens. %26lt;br%26gt;Methods. Using a Markov decision model, an acceptable incremental cost-effectiveness ratio (ICER) per progression-free life-year saved (PFLYS) was estimated. Cost of drugs, growth colony-stimulating factors, and transfusions were derived from Medicare reimbursement data. Survival and rates of complications were estimated based on the clinical trial. %26lt;br%26gt;Results. Using a body weight and surface area of an average woman age 63, the estimated cost per cycle of ddT was $107 vs. $80 for q3T. The costs per cycle of combination chemotherapy including treatment administration were $873 for ddT and $535 for q3T. With a median progression-free survival (PFS) of 28 months with ddT vs. 17.2 months with q3T, the ICER was $5809 per PFLYS for ddT compared with q3T arm. Using a maximum ICER of $100,000 per LYS as cost-effective threshold, the ddT regimen was cost-effective. The ICER was most sensitive to the hazard rate for difference in PFS between the two regimens. A 4-month difference in PFS resulted in a $1200 change of ICER per PFLYS. The ICER was also sensitive to overall survival difference, rate of hematological toxicity, and rate of discontinuation. %26lt;br%26gt;Conclusions. In this economic model, dose-dense weekly paclitaxel is a cost-effective treatment option for advanced ovarian cancer.

• 出版日期2012-2