title: Pharmacoeconomics of amifostine in ovarian cancer.
abstract: Physicians are frequently pressured to make therapeutic decisions within a cost-effective framework to demonstrate value to managed care. Because cancer is a chronic disease, health care costs are known to be expensive and physicians must use their resources as efficiently as possible. Historically, economic analyses in oncology have emphasized survival as their clinical end point. Today, both government groups and professional organizations are moving toward making quality of life the clinical end point in determining the economics of chemotherapy. This report evaluates the cost and efficacy of amifostine (Ethyol; Alza Pharmaceuticals, Palo Alto, CA/US Bioscience, West Conshohocken, PA) use in the treatment of advanced ovarian cancer using two pharmacoeconomic analyses. A cost-utility analysis performed in the United States indicated that inclusion of amifostine therapy had both a favorable clinical and cost-utility profile compared with other medical therapies. A second cost-benefit analysis, conducted in Canada, suggested that use of amifostine in patients with advanced ovarian cancer would be cost saving. Amifostine is a novel agent that protects against both chemotherapy- and radiotherapy-induced toxicities, such as nephrotoxicity, neutropenia, thrombocytopenia, peripheral neuropathy, mucositis, and xerostomia. These toxicities are disturbing to both patients and physicians alike. The results of these studies support the use of amifostine as a valuable resource both economically and clinically.
authors.affiliation: Department of Medicine, Northwestern University, Chicago, IL 60611, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Calhoun
authors.forename: C L
authors.initials: CL
authors.lastname: Bennett
mesh_terms: D004999:Amifostine / Q000191:economics* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D002170:Canada; D003362:Cost-Benefit Analysis; D019610:Cytoprotection; D005260:Female; D006801:Humans; D018803:Models, Economic; D010051:Ovarian Neoplasms / Q000191:economics / Q000628:therapy*; D020011:Protective Agents / Q000191:economics* / Q000627:therapeutic use; D019057:Quality-Adjusted Life Years; D014481:United States
chemical_list: D000970:Antineoplastic Agents; D020011:Protective Agents; D004999:Amifostine