title: Supportive Care Costs Associated with Second-Line Chemotherapy in Chinese Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer: A Retrospective Cohort Study.
abstract: OBJECTIVE
  To compare supportive care costs associated with second-line chemotherapy for advanced non-squamous non-small cell lung cancer (advNS-NSCLC) in Chinese patients.
  
  
  METHODS
  This retrospective cohort study included patients receiving pemetrexed or docetaxel-based second-line chemotherapy for advNS-NSCLC in four Chinese hospitals from 2007 to 2012. The best matched pairs between pemetrexed and other regimens were identified using propensity score methods for head-to-head comparisons of supportive care costs per treatment cycle. Linear regression analyses were performed to rank log10 scale of supportive care costs per treatment cycle associated with chemotherapy by tumor response and hematologic toxicity.
  
  
  RESULTS
  384 patients were included to create propensity score-matched treatment groups for pemetrexed singlet versus docetaxel singlet, platinum/pemetrexed, and platinum/docetaxel, respectively. Pemetrexed singlet was associated with significantly less supportive care costs per treatment cycle than the two doublets (platinum/pemetrexed: median difference -RMB 9,877, p = 0.003; platinum/docetaxel: median difference -RMB 8,370, p = 0.009; 1 RMB = 0.16 USD) but not docetaxel singlet in matched patients. Of the four studied chemotherapy regimens, pemetrexed singlet was associated with the lowest log10 scale of supportive care costs per treatment cycle in patients with tumor control (coefficient relative to docetaxel singlet -1.049, p < 0.001) or leukopenia (coefficient relative to docetaxel singlet -0.991, p = 0.034).
  
  
  CONCLUSIONS
  Pemetrexed singlet cost significantly less for supportive care than pemetrexed or docetaxel-based doublets when treating Chinese patients with AdvNS-NSCLC in the second-line setting. Pemetrexed singlet was also associated with significantly less supportive care costs per treatment cycle than docetaxel singlet in patients with tumor control or leukopenia.
authors.affiliation: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuqin
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Hunan Province Tumor Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Research and Education, Hunan Province Tumor Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Shengqi
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Respiratory, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Chenping
authors.initials: C
authors.lastname: Hu
authors.affiliation: Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai Branch, Shanghai, China.
authors.forename: Yicheng
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Global Health Outcomes Research, Eli Lilly, Indianapolis, IN, USA.
authors.forename: Narayan
authors.initials: N
authors.lastname: Rajan
authors.affiliation: Global Health Outcomes Research, Eli Lilly, Indianapolis, IN, USA.|Division of Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, 6th floor, 144 College Street, Toronto, ON, M5S 3M2, Canada.
authors.forename: Manny
authors.initials: M
authors.lastname: Papadimitropoulos
authors.affiliation: Division of Health Outcome Research, Normin Health China Office, Changsha, Hunan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Division of Health Outcome Research, Normin Health China Office, Changsha, Hunan, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Peng
authors.affiliation: Division of Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, 6th floor, 144 College Street, Toronto, ON, M5S 3M2, Canada. wendong.chen@utoronto.ca.|Normin Health, Toronto, ON, Canada. wendong.chen@utoronto.ca.
authors.forename: Wendong
authors.initials: W
authors.lastname: Chen