Economics of treatments for non-small cell lung cancer.
The purpose of this article is to review the economics of treatments for non-small cell lung cancer (NSCLC). We systematically analysed the cost effectiveness of treatments for the different stages of NSCLC, with particular emphasis on more recently approved agents. Numerous economic analyses in NSCLC have been conducted, with a variety of methods and in a number of countries. In patients with localized disease, adjuvant chemotherapy appears to have greater cost effectiveness than observation; however, there are few published data. In locally advanced disease, combined modalities (chemotherapy, surgery and/or radiotherapy) are probably cost effective, but high-quality economic analyses are lacking. In advanced NSCLC, third-generation chemotherapies used in the first-line setting can be administered with acceptable incremental cost effectiveness. In the second-line setting, new agents (docetaxel, pemetrexed and erlotinib) have acceptable cost effectiveness. The lack of cost-utility analyses for elderly patients and patients with a poor prognosis rules out firm conclusions. This review suggests that most therapies for NSCLC are cost effective when the patient has a good performance status, with an incremental cost-effectiveness ratio under USD 50,000 per life-year gained in the majority of cases.
Chouaid
Christos
C
INSERM, U707, Paris, France. christos.chouaid@sat.ap-hop-paris.fr
Atsou
Kukovi
K
Hejblum
Gilles
G
Vergnenegre
Alain
A
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D000077143:Docetaxel; D000069347:Erlotinib Hydrochloride; D005971:Glutamates / Q000191:economics / Q000627:therapeutic use; D006147:Guanine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D000068437:Pemetrexed; D011799:Quinazolines / Q000191:economics / Q000627:therapeutic use; D043823:Taxoids / Q000191:economics / Q000627:therapeutic use
D005971:Glutamates; D011799:Quinazolines; D043823:Taxoids; D000068437:Pemetrexed; D000077143:Docetaxel; D006147:Guanine; D000069347:Erlotinib Hydrochloride