title: Cost-effectiveness of bevacizumab-based therapy versus cisplatin plus pemetrexed for the first-line treatment of advanced non-squamous NSCLC in Korea and Taiwan.
abstract: OBJECTIVE
  The aim of this analysis is to investigate the mean incremental costs and life expectancy associated with two first-line treatments for advanced non-squamous non-small cell lung cancer (NSCLC) in Korea and Taiwan; bevacizumab plus cisplatin and gemcitabine (BevCG) and cisplatin plus pemetrexed (CP).
  
  
  METHODS
  A health economic (area under curve) model with three health states was developed to assess health outcomes (life-years gained [LYG]), direct costs, and incremental cost-effectiveness ratio (ICER). Progression-free survival (PFS) and overall survival (OS) were derived from randomized clinical trials and used in an indirect comparison in order to estimate their cost effectiveness. A life-time horizon was used. Costs and outcomes were discounted yearly by 5% in Korea and by 3% in Taiwan.
  
  
  RESULTS
  The incremental LYG for the BevCG patients compared with patients treated with CP were 1.10 (13.2 months) in Korea and 1.19 (14.3 months) in Taiwan. The incremental costs were 37,439,968 ($ 33,322) in Korea and NT$ 1,910,615 ($ 64,541) in Taiwan. The incremental cost-effectiveness ratio was 34,064,835 ($ 30,318) in Korea and NT$ 1,607,960 ($ 54,317) in Taiwan. The inputs tested in one-way sensitivity analyses had very little impact on the overall cost effectiveness.
  
  
  CONCLUSIONS
  This analysis shows that BevCG is more costly but is also associated with additional life-years in Korea and Taiwan. The ICER per LYG suggests that BevCG is a cost-effective therapy when compared to CP for patients with advanced NSCLC in Korea and Taiwan.
authors.affiliation: Section of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. silkahn@skku.edu
authors.forename: Myung-Ju
authors.initials: MJ
authors.lastname: Ahn
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Tsai
authors.forename: Te-Chun
authors.initials: TC
authors.lastname: Hsia
authors.forename: Elaine
authors.initials: E
authors.lastname: Wright
authors.forename: John Wen-Cheng
authors.initials: JW
authors.lastname: Chang
authors.forename: Heung Tae
authors.initials: HT
authors.lastname: Kim
authors.forename: Joo-Hang
authors.initials: JH
authors.lastname: Kim
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kang
authors.forename: Sang-We
authors.initials: SW
authors.lastname: Kim
authors.forename: Eun-Jin
authors.initials: EJ
authors.lastname: Bae
authors.forename: Mijeong
authors.initials: M
authors.lastname: Kang
authors.forename: Johanna
authors.initials: J
authors.lastname: Lister
authors.forename: Stefan
authors.initials: S
authors.lastname: Walzer
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; 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; D018572:Disease-Free Survival; D005260:Female; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007723:Korea; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000191:economics; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D016019:Survival Analysis; D013624:Taiwan
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005971:Glutamates; D000068437:Pemetrexed; D000068258:Bevacizumab; D006147:Guanine; D002945:Cisplatin