title: Economic evaluation of docetaxel-gemcitabine versus vinorelbine-cisplatin combination as front-line treatment of patients with advanced/metastatic non-small-cell lung cancer in Greece: a cost-minimization analysis.
abstract: BACKGROUND
  An economic evaluation was undertaken, alongside a randomized phase III study, to assess docetaxel-gemcitabine (DG) relative to vinorelbine-cisplatin (VC) combination as front-line treatment of patients with advanced/metastatic non-small-cell lung cancer.
  
  
  METHODS
  No differences were found in efficacy, thus a cost-minimization analysis was carried out. Treatment cost accounts for the administration of first- and second-line chemotherapy, for concomitant medications, for laboratory and biochemical examinations, and for hospitalizations due to adverse events. Unit prices used reflect 2008 and are common among National Health Service hospitals in Greece.
  
  
  RESULTS
  The mean total cost of therapy in the DG group [14045 euros, 95% uncertainty interval (UI) 12628 euros-15390 euros], was significantly higher than in the VC group (8143 euros, 95% UI 7314 euros-9067 euros).
  
  
  CONCLUSIONS
  Even though the combination VC has similar effectiveness compared with DG in patients with metastatic lung cancer, it is associated with a lower overall treatment cost and hence, it is preferable from an economic perspective. However, it should be noted that although VC is associated with lower cost, it is also more toxic than DG regimen, a significant parameter that should be considered in clinical decisions.
authors.affiliation: Department of Health Services Management, National School of Public Health, Athens. Electronic address: nmaniadakis@nsph.gr.
authors.forename: N
authors.initials: N
authors.lastname: Maniadakis
authors.affiliation: Department of Health Services Management, National School of Public Health, Athens.
authors.forename: V
authors.initials: V
authors.lastname: Fragoulakis
authors.affiliation: Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Greece.
authors.forename: A G
authors.initials: AG
authors.lastname: Pallis
authors.affiliation: Department of Health Services Management, National School of Public Health, Athens.
authors.forename: E
authors.initials: E
authors.lastname: Simou
authors.affiliation: Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Georgoulias
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000191:economics* / Q000556:secondary; D000068818:Cetuximab; D002945:Cisplatin / Q000008:administration & dosage; D003362:Cost-Benefit Analysis; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077143:Docetaxel; D005260:Female; D006115:Greece; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000191:economics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D014747:Vinblastine; D000068818:Cetuximab; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine