title: Cost effectiveness of liposomal doxorubicin vs. paclitaxel for the treatment of advanced AIDS-Kaposi's sarcoma.
abstract: OBJECTIVE
  Epidemic Kaposi's sarcoma (KS) is one of the most common acquired immune deficiency syndrome (AIDS) defining malignancies, a disease with stigmatized clinical features that characterizes the diagnosis of AIDS. This study aims to perform a cost-effectiveness analysis between liposomal doxorubicin and paclitaxel in treating AIDS-KS.
  
  
  METHODS
  A 21 week decision tree analysis was created using a hospital perspective to compare treatment patterns with liposomal doxorubicin and paclitaxel. All costs were calculated in 2011 US dollars and obtained from an academic treatment center. Acquisition costs were obtained from public estimates using wholesale acquisition cost (WAC). Effectiveness was estimated based on a Phase 3 study of liposomal doxorubicin and paclitaxel (Von-Roenn et al.). Adverse events (AEs) associated with treatment and not the disease were included in the analysis. One-way sensitivity analysis was performed to test the robustness of the results.
  
  
  RESULTS
  Cost minimization analysis showed that treatment with liposomal doxorubicin was $18,125 whereas paclitaxel costs $12,347. After accounting for response rate, the results showed that liposomal doxorubicin costs $39,403 versus $21,661 for paclitaxel. This study has some limitations. Clinical data were derived from different clinical trials. In addition, many assumptions were made.
  
  
  CONCLUSIONS
  Paclitaxel is dominant due to its lower acquisition cost and high response rate. Acquisition cost of liposomal doxorubicin and paclitaxel are significantly different. After accounting for all the factors that contribute to cost and response rate, paclitaxel is more cost effective than liposomal doxorubicin.
authors: University of Utah, Pharmacotherapy Outcomes Research Center, Salt Lake City, UT 84108, USA. karina.pupio@gmail.com
authors: Karina
authors: K
authors: Raimundo
authors: Joseph
authors: J
authors: Biskupiak
authors: Michael
authors: M
authors: Goodman
authors: Scott
authors: S
authors: Silverstein
authors: Carl
authors: C
authors: Asche
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D004317:Doxorubicin / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D008081:Liposomes; D017239:Paclitaxel / Q000191:economics* / Q000627:therapeutic use; D012514:Sarcoma, Kaposi / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D008081:Liposomes; D004317:Doxorubicin; D017239:Paclitaxel