Is paclitaxel and cisplatin a cost-effective first-line therapy for advance ovarian carcinoma?
BACKGROUND
Paclitaxel and cisplatin use for the treatment of advanced ovarian carcinoma (AOC) has been shown to increase median survival duration. An evaluation was performed on the economic consequences of treating AOC patients with combined paclitaxel and cisplatin chemotherapy compared with current usual care, i.e., combined cyclophosphamide and cisplatin chemotherapy.


METHODS
Linear modeling techniques combined with retrospective chart analysis were used to predict the clinical progression and treatment of AOC patients until death. Cost-effectiveness analysis comparing paclitaxel and cisplatin and usual care was performed from a simplified Ministry of Health perspective.


RESULTS
Assuming a 50% increase in survival for paclitaxel and cisplatin patients, an assumption supported by recent clinical trial data, this treatment showed an average lifetime cost per patient of $50,054 Cdn compared with a cost of $36,837 Cdn for usual care. The incremental cost of the paclitaxel and cisplatin treatment over the usual treatment was $20,355 Cdn per life year gained. These results withstood extensive sensitivity analyses.


CONCLUSIONS
Paclitaxel, in combination with cisplatin, appears to be a cost-effective first-line treatment for AOC. A moderate increase in incremental cost compares favorably with other life-saving strategies currently in use. As more data become available for the use of paclitaxel, this pilot study will provide a basis for more extensive economic evaluation of paclitaxel.
Covens
A
A
Toronto-Sunnybrook Regional Cancer Center, Toronto, Ontario, Canada.
Boucher
S
S
Roche
K
K
Macdonald
M
M
Pettitt
D
D
Jolain
B
B
Souetre
E
E
Rivière
M
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D016014:Linear Models; D018803:Models, Economic; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D017239:Paclitaxel / Q000008:administration & dosage / Q000191:economics; D015996:Survival Rate
D017239:Paclitaxel; D002945:Cisplatin