Cost-effectiveness analysis of bevacizumab versus pemetrexed for advanced non-squamous NSCLC in Italy.
BACKGROUND
The new targeted agent bevacizumab in combination with cisplatin and gemcitabine (BCG), and a third-generation chemotherapy pemetrexed in combination with cisplatin (PC), are approved as first-line treatment for patients with advanced non-squamous non-small cell lung cancer (NSCLC).


METHODS
An indirect comparison between BCG and PC showed that the bevacizumab triplet achieved a favourable hazard ratio in terms of progression-free survival among patients with advanced NSCLC. This analysis aimed to compare the detailed costs and benefits of these treatments for advanced non-squamous NSCLC in Italy.


RESULTS
The monthly cost of single-agent bevacizumab, including administration and supportive care costs, and costs for adverse events as a single agent was 4,007 euro/patient less than pemetrexed over the patient's lifetime. BCG also achieved a mean gain of 0.12 life-years compared with PC over this period. The incremental cost-effectiveness ratio of BCG relative to PC was calculated to be 34,919 euro per additional life-year gained suggesting that BCG is cost-effective compared with PC as first-line treatment for advanced NSCLC in Italy.


CONCLUSIONS
In conclusion, bevacizumab-based therapy can be considered as a cost-effective option when compared to chemotherapy treatments such as pemetrexed for the treatment for advanced non-squamous NSCLC.
Giuliani
Giovanni
G
Roche, Monza, Italy. Giovanni.giuliani@roche.com
Grossi
Francesco
F
de Marinis
Filippo
F
Walzer
Stefan
S
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000191:economics; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000191:economics*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use; D000068258:Bevacizumab; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000191:economics*; D002945:Cisplatin / Q000008:administration & dosage; D003362:Cost-Benefit Analysis; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D016527:Drug Costs; D005971:Glutamates / Q000008:administration & dosage / Q000191:economics*; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics; D006801:Humans; D007558:Italy; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000191:economics*; D008390:Markov Chains; D018803:Models, Economic; D000068437:Pemetrexed; D011788:Quality of Life; D000093542:Gemcitabine
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005971:Glutamates; D000068437:Pemetrexed; D003841:Deoxycytidine; D000068258:Bevacizumab; D006147:Guanine; D002945:Cisplatin; D000093542:Gemcitabine