Analysis of the cost-effectiveness of paclitaxel as alternative combination therapy for advanced ovarian cancer.
OBJECTIVE
A phase III trial by the Gynecologic Oncology Group (GOG) provides strong evidence that a new alternative therapy--paclitaxel (Taxol; Bristol-Myers Squibb Co, Princeton, NJ) in combination with cisplatin (Platinol; Bristol-Myers Squibb Co)--is clinically more effective than the standard therapy using cyclophosphamide (Cytoxan; Bristol-Myers Squibb Co) in combination with cisplatin in the treatment of advanced ovarian cancer. We conducted a pharmacoeconomic analysis to determine whether the alternative paclitaxel-cisplatin (TP) therapy is cost-effective (CE) in comparison to standard cyclophosphamide-cisplatin (CP) therapy.


METHODS
Using an economic model, we applied cost data figures to resource utilization data derived from the two arms of the GOG trial. We examined paclitaxel benefits in terms of increased mean survival time, as well as median survival time. Estimates of the cumulative proportion surviving in the trial were based on Kaplan-Meier procedures.


RESULTS
Per year of life gained (YLG), TP therapy costs more ($19,820 more for inpatient treatment; $21,222 outpatient) than CP treatment.


CONCLUSIONS
The TP regimen's increased mean survival cost per YLG (inpatient and outpatient settings) adds a substantial benefit at an acceptable cost compared with CP therapy.
McGuire
W
W
Center for Health Outcomes and Economics, East Brunswick, NJ 08816, USA.
Neugut
A I
AI
Arikian
S
S
Doyle
J
J
Dezii
C M
CM
D000970:Antineoplastic Agents / Q000191:economics; D018906:Antineoplastic Agents, Alkylating / Q000191:economics; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D002945:Cisplatin / Q000191:economics; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000191:economics; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000191:economics*; D017239:Paclitaxel / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D016019:Survival Analysis
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000972:Antineoplastic Agents, Phytogenic; D003520:Cyclophosphamide; D017239:Paclitaxel; D002945:Cisplatin