Pharmacoeconomic profile of paclitaxel as a first-line treatment for patients with advanced ovarian carcinoma. A lifetime cost-effectiveness analysis.
BACKGROUND
Analysis of published survival curves has recently been proposed as a method for conducting incremental cost-effectiveness analysis in which two treatments are compared with each other in terms of cost per year of life gained. In patients with advanced ovarian carcinoma, the combination of paclitaxel and cisplatin has been reported to improve survival more significantly than standard therapy with cyclophosphamide and cisplatin. However, the high cost of paclitaxel indicates a need for an evaluation of the pharmacoeconomic profile of these treatments.


METHODS
The authors conducted an incremental cost-effectiveness analysis to assess the paclitaxel-based regimen in terms of cost per year of life gained. The analysis utilized data from a published controlled long term trial involving 184 patients treated with paclitaxel and cisplatin and 202 patients treated with cyclophosphamide and cisplatin. Gompertz' law was employed to obtain the lifetime estimate of the years gained by patients given the first treatment in comparison with patients given the second.


RESULTS
The paclitaxel-based treatment was found to improve life expectancy by 46 years for every 100 patients. Costs of chemotherapy were higher in the paclitaxel group than in the standard-therapy group (the cost difference was $901,723 for every 100 patients; costs for treating febrile neutropenia induced by chemotherapy were taken into account). On the basis of these data of cost and effectiveness, the administration of paclitaxel and cisplatin was found to imply a cost per year of life gained of $19,603 more than standard chemotherapy.


CONCLUSIONS
The pharmacoeconomic profile of paclitaxel compares favorably with economic data previously calculated for other types of pharmacologic treatment.
Messori
A
A
Drug Information Center, Azienda Ospedaliera Careggi, Florence, Italy.
Trippoli
S
S
Becagli
P
P
Tendi
E
E
D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000191:economics / Q000627:therapeutic use; D002945:Cisplatin / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008017:Life Expectancy; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000401:mortality; D017239:Paclitaxel / Q000191:economics* / Q000627:therapeutic use; D012680:Sensitivity and Specificity
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D003520:Cyclophosphamide; D017239:Paclitaxel; D002945:Cisplatin