title: Pharmacoeconomic issues in head and neck oncology.
abstract: OBJECTIVE
  Despite medical advances, the global incidence, morbidity and mortality associated with head and neck cancer remain high. Pharmacoeconomic analyses of chemotherapeutic options commonly used by head and neck oncologists are reviewed in context with current clinical practice.
  
  
  RESULTS
  From the British health system perspective, cetuximab with radiotherapy in locally advanced head and neck was found to be cost-effective compared to single modality radiotherapy in patients with a good performance status, and in whom platinum agents are contraindicated. Induction chemotherapy with the three-drug regimen docetaxel, cisplatin and 5-fluorouracil is considered cost-effective when compared to the doublet cisplatin-5-fluorouracil from the British and Italian perspectives. However, it is unclear whether induction chemotherapy per se is effective when compared to chemoradiotherapy. Cetuximab with chemotherapy is not recommended from a British health perspective for patients with metastatic/recurrent disease, whereas it is the preferred regimen in commonly used guidelines in the US, where economic evaluations are not incorporated in the drug approval process.
  
  
  CONCLUSIONS
  The critical assessment and utilization of pharmacoeconomic evaluations, always in context with current clinical practice, should be further performed and promoted in head and neck oncology.
authors.affiliation: Section of Hematology/Oncology, The University of Chicago Medicine, Chicago, Illinois 60637-1470, USA. jdesouza@medicine.bsd.uchicago.edu
authors.forename: Jonas A
authors.initials: JA
authors.lastname: de Souza
authors.forename: Gilberto
authors.initials: G
authors.lastname: de Lima Lopes
authors.forename: Ezra E W
authors.initials: EE
authors.lastname: Cohen
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000191:economics*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000191:economics; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000191:economics / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000191:economics; D017850:Economics, Pharmaceutical; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000532:radiotherapy*; D006801:Humans; D007558:Italy; D000077195:Squamous Cell Carcinoma of Head and Neck; D006113:United Kingdom
chemical_list: D000970:Antineoplastic Agents