Economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis

VF Fragoulakis,1 AG Pallis,3 DK Kaitelidou,2 NM Maniadakis,1 VG Georgoulias31Department of Health Services Management, National School of Public Health, Athens, 2Center for Health Services Management and Evaluation, Department of Nursing, University of Athens, Athens, Greece; 3Department of Medical...

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Autores principales:	Fragoulakis VF, Pallis AG, Kaitelidou DK, Maniadakis NM, Georgoulias VG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/f1f1582fdeaf40538ee1ef2b7b85cfe5
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spelling	oai:doaj.org-article:f1f1582fdeaf40538ee1ef2b7b85cfe52021-12-02T05:02:33ZEconomic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis1179-2728https://doaj.org/article/f1f1582fdeaf40538ee1ef2b7b85cfe52012-07-01T00:00:00Zhttp://www.dovepress.com/economic-evaluation-of-pemetrexed-versus-erlotinib-as-second-line-trea-a10405https://doaj.org/toc/1179-2728VF Fragoulakis,1 AG Pallis,3 DK Kaitelidou,2 NM Maniadakis,1 VG Georgoulias31Department of Health Services Management, National School of Public Health, Athens, 2Center for Health Services Management and Evaluation, Department of Nursing, University of Athens, Athens, Greece; 3Department of Medical Oncology, University General Hospital of Heraklion, Voutes Crete, GreeceObjectives: An economic evaluation was conducted in conjunction with a prospective, multicenter, randomized trial, to compare pemetrexed with erlotinib in pretreated patients with metastatic non-small cell lung cancer (NSCLC) in Greece.Methods: The effectiveness of treatments examined was comparable; thus, cost minimization analysis was conducted to evaluate which option is less costly. Patient-level resource utilization data were combined with unit cost data, which were aggregated to compute the total treatment cost for each patient. The analysis was conducted with respect to the individual incurring the cost. Due to the limited life-expectancy of the patients, discounting was unnecessary. Since data were right censored, the Bang and Tsiatis method was employed to identify unbiased estimators of the mean cost per treatment arm, while other methods were employed for sensitivity analysis. To analyze uncertainty and to construct uncertainty intervals (UI), stochastic analysis was performed based on 5000 bootstrap replications.Results: The one-year survival rate was 28.3% in the pemetrexed arm and 31.7% in the erlotinib arm, while the corresponding median survival over the follow-up period was 7.1 and 6.7 months, respectively (P = 0.765). Total cost in the pemetrexed arm was &euro;10508 (95% UI: &euro;9552&ndash;&euro;11488), while in the erlotinib arm the cost was &euro;9563 (95% UI: &euro;8499&ndash;&euro;10711); thus, no statistically significant difference was found between the comparators (P = 0.206). Results remained constant for all sensitivity analyses.Conclusions: There is no survival or cost difference between erlotinib and pemetrexed; thus, these therapies are equivalent. Further studies are needed to determine whether other parameters, such as quality of life, differ among treatment options.Keywords: erlotinib, economic evaluation, lung cancer, pemetrexedFragoulakis VFPallis AGKaitelidou DKManiadakis NMGeorgoulias VGDove Medical PressarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol 2012, Iss default, Pp 43-51 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Fragoulakis VF Pallis AG Kaitelidou DK Maniadakis NM Georgoulias VG Economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis
description	VF Fragoulakis,1 AG Pallis,3 DK Kaitelidou,2 NM Maniadakis,1 VG Georgoulias31Department of Health Services Management, National School of Public Health, Athens, 2Center for Health Services Management and Evaluation, Department of Nursing, University of Athens, Athens, Greece; 3Department of Medical Oncology, University General Hospital of Heraklion, Voutes Crete, GreeceObjectives: An economic evaluation was conducted in conjunction with a prospective, multicenter, randomized trial, to compare pemetrexed with erlotinib in pretreated patients with metastatic non-small cell lung cancer (NSCLC) in Greece.Methods: The effectiveness of treatments examined was comparable; thus, cost minimization analysis was conducted to evaluate which option is less costly. Patient-level resource utilization data were combined with unit cost data, which were aggregated to compute the total treatment cost for each patient. The analysis was conducted with respect to the individual incurring the cost. Due to the limited life-expectancy of the patients, discounting was unnecessary. Since data were right censored, the Bang and Tsiatis method was employed to identify unbiased estimators of the mean cost per treatment arm, while other methods were employed for sensitivity analysis. To analyze uncertainty and to construct uncertainty intervals (UI), stochastic analysis was performed based on 5000 bootstrap replications.Results: The one-year survival rate was 28.3% in the pemetrexed arm and 31.7% in the erlotinib arm, while the corresponding median survival over the follow-up period was 7.1 and 6.7 months, respectively (P = 0.765). Total cost in the pemetrexed arm was &euro;10508 (95% UI: &euro;9552&ndash;&euro;11488), while in the erlotinib arm the cost was &euro;9563 (95% UI: &euro;8499&ndash;&euro;10711); thus, no statistically significant difference was found between the comparators (P = 0.206). Results remained constant for all sensitivity analyses.Conclusions: There is no survival or cost difference between erlotinib and pemetrexed; thus, these therapies are equivalent. Further studies are needed to determine whether other parameters, such as quality of life, differ among treatment options.Keywords: erlotinib, economic evaluation, lung cancer, pemetrexed
format	article
author	Fragoulakis VF Pallis AG Kaitelidou DK Maniadakis NM Georgoulias VG
author_facet	Fragoulakis VF Pallis AG Kaitelidou DK Maniadakis NM Georgoulias VG
author_sort	Fragoulakis VF
title	Economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis
title_short	Economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis
title_full	Economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis
title_fullStr	Economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis
title_full_unstemmed	Economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis
title_sort	economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in greece: a cost minimization analysis
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/f1f1582fdeaf40538ee1ef2b7b85cfe5
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Economic evaluation of pemetrexed versus erlotinib as second-line treatment of patients with advanced/metastatic non-small cell lung cancer in Greece: a cost minimization analysis

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