title: Cost-effectiveness analysis of pemetrexed versus docetaxel in the second-line treatment of non-small cell lung cancer in Spain: results for the non-squamous histology population.
abstract: BACKGROUND
  The objective of this study was to conduct a cost-effectiveness evaluation of pemetrexed compared to docetaxel in the treatment of advanced or metastatic non-small cell lung cancer (NSCLC) for patients with predominantly non-squamous histology in the Spanish healthcare setting.
  
  
  METHODS
  A Markov model was designed consisting of stable, responsive, progressive disease and death states. Patients could also experience adverse events as long as they received chemotherapy. Clinical inputs were based on an analysis of a phase III clinical trial that identified a statistically significant improvement in overall survival for non-squamous patients treated with pemetrexed compared with docetaxel. Costs were collected from the Spanish healthcare perspective.
  
  
  RESULTS
  Outcomes of the model included total costs, total quality-adjusted life years (QALYs), total life years gained (LYG) and total progression-free survival (PFS). Mean survival was 1.03 years for the pemetrexed arm and 0.89 years in the docetaxel arm; QALYs were 0.52 compared to 0.42. Per-patient lifetime costs were 34677 euros and 32343 euros, respectively. Incremental cost-effectiveness ratios were 23967 euros per QALY gained and 17225 euros per LYG.
  
  
  CONCLUSIONS
  Pemetrexed as a second-line treatment option for patients with a predominantly non-squamous histology in NSCLC is a cost-effective alternative to docetaxel according to the 30000 euros /QALY threshold commonly accepted in Spain.
authors.affiliation: IMS Health, 7 Harewood Avenue, NW1 6JB, London, UK. yasukai@uk.imshealth.com
authors.forename: Yumi
authors.initials: Y
authors.lastname: Asukai
authors.forename: Amparo
authors.initials: A
authors.lastname: Valladares
authors.forename: Carlos
authors.initials: C
authors.lastname: Camps
authors.forename: Eifiona
authors.initials: E
authors.lastname: Wood
authors.forename: Kaisa
authors.initials: K
authors.lastname: Taipale
authors.forename: Jorge
authors.initials: J
authors.lastname: Arellano
authors.forename: Alejo
authors.initials: A
authors.lastname: Cassinello
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Sacristán
authors.forename: Tatiana
authors.initials: T
authors.lastname: Dilla
mesh_terms: D002277:Carcinoma / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D045744:Cell Line, Tumor; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; 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*; D008297:Male; D008390:Markov Chains; D000068437:Pemetrexed; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013030:Spain; D043823:Taxoids / Q000191:economics* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005971:Glutamates; D043823:Taxoids; D000068437:Pemetrexed; D000077143:Docetaxel; D006147:Guanine