Cost analysis of hospital treatment--two chemotherapic regimens for non-surgical non-small cell lung cancer. GFPC (Groupe Français Pneumo Cancérologie)
OBJECTIVE
compare the costs of two regimens of chemotherapy. Apply weighted costs to an economic model in a hospital perspective.


METHODS
prospective randomized study of two groups of patients receiving: branch B, mitomycin-navelbine-cisplatin (MNP); branch A, mitomycin-vindesine-cisplatin (MVP).


METHODS
pneumologic units of University and non-University hospitals.


METHODS
clinical evaluation during chemotherapy incorporated events enabling construction of an event tree. Direct hospital costs included those of: cytostatic agents, materials used and nursing time; costs of side-effects (medical and paramedical time, diagnostic and therapeutic examinations). Effectiveness was measured in terms of response rates.


METHODS
209 patients were included, 100 in arm B, 109 in arm A.


RESULTS
the response rates were 25% in branch B, 17% in branch A. In the hypothesis of equivalence of the two strategies, we compared only overall mean cost per patient. Despite the fact arm B needed more hospital injections, the difference was low (+4.6%). For a difference in effectiveness, the opposite was observed for the average cost-effectiveness ratio: arm B was less costly (-12 339.40 FF for a responder).


CONCLUSIONS
incorporation of economic parameters was found to have a bearing on the choice of chemotherapeutic regimen for the treatment of non-small cell lung cancer. Economic analyses of this kind can provide useful extra information for rational therapeutic decisions.
Vergnenègre
A
A
Service de Pneumologie, Hôpital Universitaire du Cluzeau, Limoges, France.
Perol
M
M
Pham
E
E
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000191:economics / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000191:economics*; D002945:Cisplatin / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004180:Direct Service Costs / Q000706:statistics & numerical data; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006302:Health Services Research / Q000379:methods; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000191:economics*; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000191:economics / Q000627:therapeutic use; D018803:Models, Economic; D016522:Oncology Service, Hospital / Q000191:economics*; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014747:Vinblastine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D014751:Vindesine / Q000191:economics / Q000627:therapeutic use; D000077235:Vinorelbine
D000903:Antibiotics, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D008937:Mitomycins; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine; D014751:Vindesine