Cost-effectiveness of three strategies for second-line erlotinib initiation in nonsmall-cell lung cancer: the ERMETIC study part 3
| Autor: | Nicolas Richard, Pierre Hainaut, Bruno Coudert, Xavier Sastre-Garau, Jean-Luc Prétet, Yves-Marie ROBIN, Christos Chouaid, Stefan Michiels, Pierre-Emmanuel Falcoz, Pascal Reynier, Marie Wislez, CHRISTIANE MOUGIN, Patrice VIENS, Helene Blons, Isabelle Borget, Jean-Pierre PIGNON, Denis MORO-SIBILOT, Ivan Bieche |
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| Přispěvatelé: | Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Centre de compétences pour les maladies pulmonaires rares, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHU Strasbourg, Département de Biologie et pathologie des tumeurs [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Hôpital Foch [Suresnes], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université de Lille-UNICANCER |
| Rok vydání: | 2011 |
| Předmět: |
Male
Oncology Lung Neoplasms Cost effectiveness Cost-Benefit Analysis Medical Oncology MESH: ErbB Receptors 0302 clinical medicine Quality of life Carcinoma Non-Small-Cell Lung MESH: Erlotinib Hydrochloride MESH: Protein Kinase Inhibitors 030212 general & internal medicine Epidermal growth factor receptor 10. No inequality Erlotinib Hydrochloride MESH: Medical Oncology MESH: Aged MESH: Middle Aged biology Middle Aged Markov Chains 3. Good health ErbB Receptors MESH: Quinazolines Docetaxel 030220 oncology & carcinogenesis Adenocarcinoma Female Erlotinib medicine.drug Pulmonary and Respiratory Medicine medicine.medical_specialty MESH: Mutation [SDV.CAN]Life Sciences [q-bio]/Cancer Sensitivity and Specificity 03 medical and health sciences MESH: Markov Chains Internal medicine Carcinoma medicine Humans Protein Kinase Inhibitors neoplasms Aged MESH: Humans business.industry MESH: Quality of Life medicine.disease MESH: Male MESH: Sensitivity and Specificity MESH: Lung Neoplasms respiratory tract diseases Surgery Mutation Quality of Life Quinazolines biology.protein business MESH: Female MESH: Carcinoma Non-Small-Cell Lung MESH: Cost-Benefit Analysis |
| Zdroj: | European Respiratory Journal European Respiratory Journal, European Respiratory Society, 2011, 39 (1), pp.172-179. ⟨10.1183/09031936.00201210⟩ European Respiratory Journal, 2011, 39 (1), pp.172-179. ⟨10.1183/09031936.00201210⟩ |
| ISSN: | 1399-3003 0903-1936 |
| DOI: | 10.1183/09031936.00201210 |
| Popis: | International audience; Several clinical and biological parameters are known to influence the efficacy of second-line erlotinib therapy for nonsmall cell lung cancer (NSCLC), but their medico-economic impact has not been evaluated. The objective of this study was to compare the incremental cost-effectiveness ratios of strategies for second-line erlotinib initiation in NSCLC: clinically guided initiation (nonsmoking females with adenocarcinoma received erlotinib; all other patients received docetaxel) and biologically guided selection (patients with epidermal growth factor receptor (EGFR) mutation received erlotinib; patients with wild-type EGFR or unknown status received docetaxel), compared with initiation with no patient selection (strategy reference). A Markov model was constructed. Outcomes (overall and progression-free survival), transition probabilities and direct medical costs (from the French third-party payer's perspective) were prospectively collected for individual patients treated with either erlotinib or docetaxel, from treatment initiation to disease progression. Published data were used to estimate utilities and post-progression costs. Sensitivity analyses were performed. The biologically and clinically guided strategies were both more efficient (incremental quality-adjusted life-yrs equal to 0.080 and 0.081, respectively) and less expensive (cost decrease equal to €5,020 and €5,815, respectively) than the no-selection strategy, and the biologically guided strategy was slightly less expensive than the clinically guided strategy. Sensitivity analyses confirmed the robustness of the results. The cost-effectiveness of second-line NSCLC treatment is improved when patients are selected on either clinical or biological grounds. |
| Databáze: | OpenAIRE |
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