PharmacoEconomics & Outcomes News 695, p8 - 1 Feb 2014

Platinum-based chemo costeffective in the real world

Using real-world data, US researchers have shownthat platinum-based chemotherapy in women withovarian cancer, is cost effective compared withnonplatinum chemotherapy, platinum plus taxanechemotherapy, and no chemotherapy.

The Surveillance, Epidemiology, and End Results(SEER)-Medicare database was used to gather data onwomen diagnosed with ovarian cancer as the firstprimary tumour at age 65 years or older, from 1 January1991 to 31 December 2005. Overall survival andadverse events (alopecia, nausea/vomiting, fatigue,neutropenia, myalgia/pain, stomatitis, and peripheralneuropathy) were used to determine treatmenteffectiveness, adjusted using utility weights frompublished literature. Costs were estimated from a payerperspective and included inpatient services, outpatientvisits and procedures, physician fees, skilled nursingfacility, hospice, and costs for devices and medicalequipment. Since the study covered a 16-year period,costs were aggregated, adjusted for inflation, andexpressed in 2009 US dollars.

Results showed that 6856 ovarian cancer patientswere identified from the database, of which 2255 (33%)received platinum and taxane therapy, 2093 (31%)received no chemotherapy, 1335 (19%) received othernonplatinum chemotherapy, and 1173 (17%) receivedonly platinum-based chemotherapy. For early stagedisease, the "other nonplatinum chemotherapy" groupincurred the highest cost ($US126 376), followed by the"platinum plus taxane" group ($122 631). For late-stagepatients, the "platinum and taxane" group had thehighest cost ($149 669) followed by the "othernonplatinum chemotherapy" group ($140 947). Patientsin the "platinum-based chemotherapy" group had thelongest mean life years and QALYs. For both early andlate-stage disease, the "other nonplatinumchemotherapy" and "platinum and taxane " groups weredominated by the "platinum-based chemotherapy"group, while the ICER* for the "platinum-basedchemotherapy" group compared with the "nochemotherapy" group was $30 073 and $58 151 forearly-stage and late-stage patients, respectively.

The authors say that the "methodology and novelty ofthe approach to real-world population-based patientdata can be applied to answer similar questions forpatients with other tumors and serve as a reference toother investigators".* incremental cost-effectiveness ratio

Lairson DR, et al. Cost-Utility Analysis of Platinum-Based Chemotherapy versusTaxane and Other Regimens for Ovarian Cancer. Value in Health 17: 34-42, No. 1,Jan 2014 803098843

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PharmacoEconomics & Outcomes News 1 Feb 2014 No. 6951173-5503/14/0695-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved