Cost-effectiveness of real-world administration of chemotherapy and add-on Viscum album L. therapy compared to chemotherapy alone in the treatment of stage IV NSCLC patients

Abstract

Background: For stage IV lung cancer patients receiving add-on Viscum album L. treatment an improved overall survival (OS) was observed. Only limited information regarding cost-effectiveness (CE) for comparisons between standard of care and standard of care plus add-on VA in stage IV lung cancer treatment is available. The present study assessed the costs and cost-effectiveness of standard of care plus VA (V) compared to standard of care alone (C) for stage IV non-small cell lung cancer (NSCLC) patients treatment in a hospital in Germany. Methods: An observational study was conducted using data from the Network Oncology clinical registry. Patients included had stage IV lung cancer at diagnosis and received C or V treatment in a certified German Cancer Center. Cost and cost-effectiveness analyses (CEA) including the analysis of the incremental cost-effectiveness ratios (ICER) were performed from the hospital′s perspective based on routine data from financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis. Results: 118 patients (C: n=86, V: n=32) were included, mean age 63.8 years, proportion of male patients 55.1%. Adjusted hospital′s total mean costs for patients from the C and V group were €16,289 (over an adjusted mean OS time of 13.4 months) and €17,992 (over an adjusted mean OS time of 19.1 months), respectively. The costs per additional OS year gained (ICER) with the V-treatment compared to C were €3,586. Conclusion: Based on our analysis, the assessment of inpatient costs and cost-effectiveness of IO concepts in stage IV lung cancer suggests that the combined use of chemotherapy and VA is clinically effective and was comparably cost-effective to chemotherapy alone in our analysed patient sample. Further randomized and prospective cost-effectiveness studies are mandatory to complement our findings.