title: Economic analysis of NCIC CTG JBR.10: a randomized trial of adjuvant vinorelbine plus cisplatin compared with observation in early stage non-small-cell lung cancer--a report of the Working Group on Economic Analysis, and the Lung Disease Site Group, National Cancer Institute of Canada Clinical Trials Group.
abstract: OBJECTIVE
  National Cancer Institute of Canada Clinical Trials Group JBR.10 study is among the landmark trials that have established third generation platinum-based adjuvant chemotherapy as the standard of care after resection of stages IB-II NSCLC, improving absolute 5-year survival by 15% and median survival by 21 months. This cost-effectiveness analysis of adjuvant chemotherapy from the perspective of Canada's public health care system was undertaken based on the JBR.10 study population.
  
  
  METHODS
  The primary outcome of the study was the incremental cost effectiveness ratio (ICER) expressed in dollars per life-year gained (LYG). Direct medical resource utilization data were collected retrospectively from trial data and medical records of patients enrolled in the JBR.10 study at the five largest accruing Canadian centers, from the time of random assignment until death or study closure (April 2004). Survival and available costs (2005 Canadian dollars [$CAD]) are presented both with and without discounting at 5% per year.
  
  
  RESULTS
  Utilization data were collected from 172 Canadian patients (36% of the trial population), 85 randomly assigned to observation and 87 randomly assigned to chemotherapy. The mean costs of treatment per patient in the observation and adjuvant chemotherapy arms were $23,878 and $31,319, respectively, with an ICER of CAD$7,175/LYG discounted (95% CI, -$3,463 to $41,565), and $10,096/LYG undiscounted (95% CI, -$819 to $55,651).
  
  
  CONCLUSIONS
  Adjuvant vinorelbine plus cisplatin is a highly cost effective treatment that compares very favorably with other standard health care interventions.
authors.affiliation: Department of Hematology and Medical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada.
authors.forename: Raymond
authors.initials: R
authors.lastname: Ng
authors.forename: Baktiar
authors.initials: B
authors.lastname: Hasan
authors.forename: Nicole
authors.initials: N
authors.lastname: Mittmann
authors.forename: Marie
authors.initials: M
authors.lastname: Florescu
authors.forename: Frances A
authors.initials: FA
authors.lastname: Shepherd
authors.forename: Keyue
authors.initials: K
authors.lastname: Ding
authors.forename: Charles Andrew
authors.initials: CA
authors.lastname: Butts
authors.forename: Yvon
authors.initials: Y
authors.lastname: Cormier
authors.forename: Gail
authors.initials: G
authors.lastname: Darling
authors.forename: Glenwood D
authors.initials: GD
authors.lastname: Goss
authors.forename: Richard
authors.initials: R
authors.lastname: Inculet
authors.forename: Lesley
authors.initials: L
authors.lastname: Seymour
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Winton
authors.forename: William K
authors.initials: WK
authors.lastname: Evans
authors.forename: Natasha B
authors.initials: NB
authors.lastname: Leighl
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine