title: An economic analysis of dose dense weekly paclitaxel plus carboplatin versus every-3-week paclitaxel plus carboplatin in the treatment of advanced ovarian cancer.
abstract: OBJECTIVE
  Compared with every-3-week paclitaxel (q3T) plus carboplatin, dose-dense weekly paclitaxel (ddT) plus carboplatin improved the survival of ovarian cancer patients. We performed a cost analysis comparing these two regimens.
  
  
  METHODS
  Using a Markov decision model, an acceptable incremental cost-effectiveness ratio (ICER) per progression-free life-year saved (PFLYS) was estimated. Cost of drugs, growth colony-stimulating factors, and transfusions were derived from Medicare reimbursement data. Survival and rates of complications were estimated based on the clinical trial.
  
  
  RESULTS
  Using a body weight and surface area of an average woman age 63, the estimated cost per cycle of ddT was $107 vs. $80 for q3T. The costs per cycle of combination chemotherapy including treatment administration were $873 for ddT and $535 for q3T. With a median progression-free survival (PFS) of 28 months with ddT vs. 17.2 months with q3T, the ICER was $5809 per PFLYS for ddT compared with q3T arm. Using a maximum ICER of $100,000 per LYS as cost-effective threshold, the ddT regimen was cost-effective. The ICER was most sensitive to the hazard rate for difference in PFS between the two regimens. A 4-month difference in PFS resulted in a $1200 change of ICER per PFLYS. The ICER was also sensitive to overall survival difference, rate of hematological toxicity, and rate of discontinuation.
  
  
  CONCLUSIONS
  In this economic model, dose-dense weekly paclitaxel is a cost-effective treatment option for advanced ovarian cancer.
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Creighton University School of Medicine at St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
authors: Heather J
authors: HJ
authors: Dalton
authors: Xinhua
authors: X
authors: Yu
authors: Lilian
authors: L
authors: Hu
authors: Daniel S
authors: DS
authors: Kapp
authors: Ivor
authors: I
authors: Benjamin
authors: Bradley J
authors: BJ
authors: Monk
authors: John K
authors: JK
authors: Chan
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000191:economics*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D016527:Drug Costs; D005260:Female; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000191:economics*; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D016016:Proportional Hazards Models
chemical_list: D016190:Carboplatin; D017239:Paclitaxel