[Pharmacoeconomic assessment of taxanes as first-line therapy for advanced or metastatic non-microcytic lung cancer].
OBJECTIVE
The goal of this study was to determine the effectiveness of taxane-containing regimens versus non-taxane-containing regimens using a metanalysis and its subsequent pharmacoeconomic assessment to define the role of taxanes as first-line therapy for non micro-cytic lung cancer.


METHODS
A search of the MEDLINE database from 2000 to June 2005 was performed. The search was restricted to phase-III clinical trials, and 29 papers were selected. Effectivity measures considered included: objective response, 1- and 2-year survival. Maentel-Haenszel combined odds ratio (OR) was estimated in the metanalysis. The statistical analysis of effectiveness across categories was performed using a one-way analysis of variance (ANOVA). Differences were statistically considered for p values = 0.01. All results obtained were weighted according to number of patients.


RESULTS
OR estimates for the various effectiveness variables showed statistically significant differences when 2-year survival was considered both for taxanes in general and docetaxel specifically versus non-taxane regimens. These same results are seen when the effectiveness analysis is performed using ANOVA. For the pharmacoeconomic analysis taxane-free regimens were considered as reference, this being of choice for comparisons versus paclitaxel-containing regimens whereas the selection of docetaxel-containing schemes represents additional costs per extra effectiveness unit that oscillate between 26,559 and 96,527 (2-year survival and objective response, respectively) versus taxane-free regimens. The sensitivity analysis ultimately confirmed our study s results.


CONCLUSIONS
To conclude, taxane-containing schemes are valid therapeutic options, but at a very high cost.
Ferriols Lisart
F
F
Servicio de Farmacia, Hospital Clínico Universitario, Valencia. Ferriols_fra@gva.es
Pitarch Molina
J
J
Magraner Gil
J
J
D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000556:secondary; D003365:Costs and Cost Analysis; D018450:Disease Progression; D000077143:Docetaxel; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000191:economics* / Q000627:therapeutic use*; D043823:Taxoids / Q000191:economics* / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel