Economic impact of gefitinib for refractory non-small-cell lung cancer: a Markov model-based analysis.
Few data are available on the economics of target therapy or refractory non-small-cell lung cancer (NSCLC).


OBJECTIVE
To determine the mean global management costs (MC) per patient treated with gefitinib for NSCLC, and the costs of the different management phases.


METHODS
A Markov approach was used to model treatment costs in a cohort of 106 patients treated with gefitinib as part of a compassionate-use program (third-line treatment) in six public-sector teaching hospitals. The economic analysis adopted the health care payer's perspective, and only direct costs were taken into account.


RESULTS
The mean duration of gefitinib treatment was 4.6 +/- 5.8 months (1-29 months); median survival was 4 months, 1-year and 2-year survival rates were 12.3% and 4.7%, respectively. The mean total management cost was 39,979 euros +/- 20,279. The model showed that first- and second-line treatments accounted for respectively 29.5% and 44.1% of this cost, while gefitinib periods represented 10.7%, periods of remission 1.25%, and terminal care 14.5%. A sensitivity analysis showed that the price of gefitinib had little influence on the total cost.


CONCLUSIONS
The cost of third-line gefitinib therapy for NSCLC appears acceptable from the healthcare payer's perspective, but this needs to be confirmed in dedicated cost-effectiveness studies.
Chouaid
Christos
C
Inserm unit U707, APHP, Paris, France. christos.chouaid@sat.ap-hop-paris.fr
Monnet
Isabelle
I
Robinet
Gilles
G
Perol
Maurice
M
Fournel
Pierre
P
Vergnenegre
Alain
A
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000191:economics*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D003365:Costs and Cost Analysis; D016527:Drug Costs; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D011799:Quinazolines / Q000008:administration & dosage / Q000191:economics*; D016019:Survival Analysis
D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib