Assessing the Potential Cost-Effectiveness of Alternative Methods to Screen for Cervical Cancer Among HIV-Positive Women in Kenya

Abstract

Objectives: Clinicians treating patients with advanced NSCLC have a range of options for care. The objective of this study was to develop a cost-effectiveness (CE) model to compare induction-maintenance sequences approved for use in the U.S. for the treatment of advanced non-squamous NSCLC given the absence of direct head-to-head trials. MethOds: The modelled regimens that were licensed in the United States included pemetrexed+cisplatin followed by (→ ) pemetrexed; pemetrexed+cisplatin→ best supportive care (BSC); gemcitabine+cisplatin→ BSC; gemcitabine+cisplatin→ erlotinib; gemcitabine+cisplatin→ pemetrexed; and pac litaxel+carboplatin+bevacizumab→ bevacizumab. Treatment effects of induction and maintenance on survival endpoints were obtained using data from a previous network meta-analysis. Decision analytic modelling was used to synthesise the treatment effect and baseline risk estimates for the induction and maintenance treatment sequences. The CE model was structured using an area-underthe-curve approach, costs and benefits were discounted at 3.5% per annum, and probabilistic and one-way sensitivity analyses were conducted to evaluate model parameters. Results: All active maintenance therapy-containing regimens, with the exception of gemcitabine+cisplatin→ erlotinib, were more costly than induction-only regimens.