Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jan 29:10:26.
doi: 10.1186/1471-2407-10-26.

Cost-effectiveness analysis of pemetrexed versus docetaxel in the second-line treatment of non-small cell lung cancer in Spain: results for the non-squamous histology population

Yumi Asukai  1 , Amparo Valladares, Carlos Camps, Eifiona Wood, Kaisa Taipale, Jorge Arellano, Alejo Cassinello, José Antonio Sacristán, Tatiana Dilla
Affiliations

Cost-effectiveness analysis of pemetrexed versus docetaxel in the second-line treatment of non-small cell lung cancer in Spain: results for the non-squamous histology population

Yumi Asukai et al. BMC Cancer. .

Abstract

Background: The objective of this study was to conduct a cost-effectiveness evaluation of pemetrexed compared to docetaxel in the treatment of advanced or metastatic non-small cell lung cancer (NSCLC) for patients with predominantly non-squamous histology in the Spanish healthcare setting.

Methods: A Markov model was designed consisting of stable, responsive, progressive disease and death states. Patients could also experience adverse events as long as they received chemotherapy. Clinical inputs were based on an analysis of a phase III clinical trial that identified a statistically significant improvement in overall survival for non-squamous patients treated with pemetrexed compared with docetaxel. Costs were collected from the Spanish healthcare perspective.

Results: Outcomes of the model included total costs, total quality-adjusted life years (QALYs), total life years gained (LYG) and total progression-free survival (PFS). Mean survival was 1.03 years for the pemetrexed arm and 0.89 years in the docetaxel arm; QALYs were 0.52 compared to 0.42. Per-patient lifetime costs were 34677 euros and 32343 euros, respectively. Incremental cost-effectiveness ratios were 23967 euros per QALY gained and 17225 euros per LYG.

Conclusions: Pemetrexed as a second-line treatment option for patients with a predominantly non-squamous histology in NSCLC is a cost-effective alternative to docetaxel according to the 30000 euros /QALY threshold commonly accepted in Spain.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Model schematic. Diagrammatic view of the model structure comprising three main health states: Stable, Response and Progression. (FN: febrile neutropenia; AE: adverse event)
Figure 2
Figure 2
Overall survival curve; model output. Modelled survival curve using data from the JMEI trial demonstrates that pemetrexed has improved overall survival compared to docetaxel. (PEM: pemetrexed; DOC: docetaxel)
Figure 3
Figure 3
One way sensitivity analysis tornado diagram ICER results. CI: confidence interval; PEM: pemetrexed; DOC: docetaxel; AE: adverse events; FN: febrile neutropenia; BSC: best supportive care Results from the one way sensitivity analysis demonstrate that the model is primarily sensitive to the 95% CI for the survival hazard ratio comparing pemetrexed versus docetaxel.
Figure 4
Figure 4
CEAC, cost per QALY pemetrexed compared to docetaxel as the reference. CEAC: cost-effectiveness acceptability curve; QALY: quality-adjusted life year; ICER: incremental cost-effectiveness ratio. The cost effectiveness acceptability curve demonstrates the likelihood of pemetrexed being cost-effective compared to docetaxel at each ICER threshold value for cost per QALY and cost per LYG.
Figure 5
Figure 5
CEAC, cost per LYG pemetrexed compared to docetaxel as the reference. CEAC: cost-effectiveness acceptability curve; QALY: quality-adjusted life year; ICER: incremental cost-effectiveness ratio
Figure 6
Figure 6
cost-effectiveness plot, cost per QALY. QALY: quality adjusted life year; CE: cost-effectiveness The majority of simulations from the PSA are in the top right quadrant demonstrating the confidence limits that surround the base case scenario. Threshold values at € 30000, € 60000 and € 90000 have been added to show the number of iterations that fall within each ICER threshold.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96. doi: 10.3322/CA.2007.0010. - DOI - PubMed
    1. Hérnandez IS, Alonso JL, Sánchez CA. [Epidemiology of lung cancer in Spain and forecast for the future] Arch Bronconeumol. 2006;42:594–599. - PubMed
    1. Cayuela A, Rodríguez-Domínguez S, López-Campos JL, Vigil E, Otero R. [Lung cancer mortality trends in Spain between 1980 and 2005] Arch Bronconeumol. 2008;44:70–74. - PubMed
    1. Alonso-Fernández MA, García-Clemente M, Escudero-Bueno C. Grupo ASTURPAR (Sociedad Asturiana de Patología del Aparato Respiratorio) del Cáncer del Pulmón (GACP) [Characteristics of lung cancer in a region in northern Spain] Arch Bronconeumol. 2005;41:478–483. - PubMed
    1. Gridelli C, Ardizzoni A, Ciardiello F, Hanna N, Heymach JV, Perrone F. Second-line treatment of advanced non-small cell lung cancer. J Thorac Oncol. 2008;3:430–440. doi: 10.1097/JTO.0b013e318168c815. - DOI - PubMed

Publication types

MeSH terms

-