Comparative cost-minimisation of oral and intravenous chemotherapy for first-line treatment of non-small cell lung cancer in the UK NHS system.
The National Institute for Health and Clinical Excellence recommends vinorelbine (VNB), paclitaxel, docetaxel, and gemcitabine in the treatment of non-small cell lung cancer. An economic model was prepared to determine the comparative cost of these agents, including the new oral formulation of VNB from a United Kingdom National Health System perspective. Clinical effectiveness was determined from published trials. Costs of drug acquisition, administration, toxicity management, and patient transportation costs were calculated from reference publications. A Markov model was used to estimate the cost per patient over 52 weeks. Intravenous VNB, gemcitabine, paclitaxel, and docetaxel incur annual follow-up costs of 3,746 pounds, 5,332 pounds, 5,977 pounds, and 6,766 pounds, respectively, while oral VNB with outpatient administration on d1, and self-administration at home on d8 every 21 days has a cost per patient per year of 2,888 pounds. Oral VNB allows further hospital resources savings.
Le Lay
K
K
REES France, 28 rue d'Assas, 75 006, Paris, France. reesfrance@wanadoo.fr
Myon
E
E
Hill
S
S
Riou-Franca
L
L
Scott
D
D
Sidhu
M
M
Dunlop
D
D
Launois
R
R
D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000191:economics*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D003365:Costs and Cost Analysis; D004333:Drug Administration Routes; D006699:Home Care Services; D006801:Humans; D007262:Infusions, Intravenous; D013222:State Medicine; D006113:United Kingdom
D000970:Antineoplastic Agents