Cost-Effectiveness of Pemetrexed Plus Cisplatin as First-Line Therapy for Advanced Nonsquamous Non-small Cell Lung Cancer

Abstract

Compared with commonly used and reimbursed regimens for first-line chemotherapy in advanced NSCLC, Cis/Pem may be considered cost-effective, particularly in patients with nonsquamous cell histology. This analysis emphasizes the importance of histology in identifying the appropriate patient for Cis/Pem first-line chemotherapy.

A Trial-Based Assessment of the Cost-Utility of Bevacizumab and Chemotherapy versus Chemotherapy Alone for Advanced Non-Small Cell Lung Cancer

“…Only one of these cost-effectiveness analysis (CEAs) included QALYs as an outcome of interest, but all three CEAs and our study used survival as a common outcome measure to determine ICERs. Klein et al reported an ICER of $337,179 per life-year gained (LY) for carboplatin, paclitaxel, and bevacizumab (as used in the ECOG 4599 trial) compared with cisplatin and pemetrexed, suggesting that the addition of bevacizumab is not cost-effective when compared with more recent and expensive regimens [10]. Grusenmeyer et al [12] performed a CEA similar to our study, based on the ECOG 4599 trial, and reported an ICER of $345,762/LY, which is similar to the ICER we report ($309,000/LY).…”

“…Three studies have addressed the cost-effectiveness of the addition of bevacizumab to chemotherapy in NSCLC [10 -12]. Two of these studies used indirect treatment comparison methods to determine the cost-effectiveness of cisplatin and pemetrexed relative to other regimens including carboplatin, paclitaxel, and bevacizumab [10] and to determine the cost-effectiveness of cisplatin, gemcitabine, and bevacizumab versus cisplatin and pemetrexed [11]. The third study reported a cost-effectiveness ratio of US$345,762 per year of life gained for the addition of bevacizumab to carboplatin and paclitaxel [12].…”

Le coût du traitement des cancers bronchopulmonaires non à petites cellules (CBNAPC)

“…Klein et al [17] ont réalisé en 2009 une analyse coût-efficacité du pemetrexed en première ligne dans l'essai CBPNAPC non épider-moïde. Il s'agissait de l'analyse coût-efficacité de l'article comparant l'utilisation de cisplatine et de pemetrexed en première ligne dans les CBP NAPC non épidermoïdes avec d'autres types de chimiothérapie Tableau 2.…”

Pharmacoeconomic analysis of consolidation therapy with pemetrexed after first-line chemotherapy for non-small cell lung cancer

“…Several pharmacoeconomic analyses of pemetrexed for firstline and second-line treatment have been reported [15][16][17]. However, economic assessments for maintenance/consolidation therapy are limited, with only a single analysis having been performed in a US population [18].…”