COST-UTILITY ANALYSIS OF PACLITAXEL IN COMBINATION WITH CISPLATIN FORPATIENTS WITH ADVANCED OVARIAN-CANCER

The standard treatment for patients with advanced ovarian cancer (AOC) has been cyclophosphamide and cisplatin (CP). Recently, the results o f a large randomized comparative trial demonstrated that the combinati on of paclitaxel and cisplatin (TP) provided a progression-free surviv al benefit of 5 months. In this study, a cost-utility analysis was per formed from a Canadian health care system perspective to estimate the incremental cost-effectiveness of the TP combination. Twelve AOC patie nts who received treatment with TP were matched for age and disease st age on a 1-to-2 basis with a CP control. Total hospital resource consu mption was then collected for all patients. Treatment preferences were estimated from a cohort of 20 patients and 40 healthy female voluntee rs using the time tradeoff technique. The outcomes were then generated through a decision-analytic model. First-line treatment costs with TP were approximately fourfold greater on a per-cycle basis than the CP alternative (Can$1911 vs Can$459). When progression-free survival bene fit and patient treatment preferences were incorporated into the analy sis, the results of the decision model revealed an incremental cost be tween Can$12,000 and Can$24,000 per quality-adjusted progression-free year with the TP protocol. Even though the TP combination has a consid erably higher drug acquisition cost, the results of the current analys is suggest that this new chemotherapy regimen does provide patients wi th substantial quality-adjusted progression-free survival benefit at a reasonable cost to the Canadian health care system. (C) 1997 Academic Press.