GEMCITABINE - CLINICAL AND ECONOMIC-IMPACT IN INOPERABLE NON-SMALL-CELL LUNG-CANCER

This study assesses retrospectively the clinical and economic impact o f gemcitabine monotherapy on the management of inoperable stage III/IV non-small cell lung cancer in Germany. Based on current methods of cl inical practice and using the best outcome data available, the costs a nd benefits of gemcitabine were compared to a dual therapy (ifosfamide /etoposide). While the two treatments showed broadly equivalent effica cy in terms of tumour response rate and survival, a cost analysis show ed the potential for savings with gemcitabine, These largely related t o hospital hotelling costs, due to the fact that gemcitabine may be gi ven as an out-patient therapy. Further savings were found in investiga tive procedures and the management of treatment toxicity. Excluding th e cost of the chemotherapy, gemcitabine was associated with potential savings of DM3,026 over two cycles of therapy, which included a 40% de crease in hospitalization costs and a 54% decrease in the cost of mana ging adverse events. We conclude that gemcitabine monotherapy could of fer considerable cost savings while offering the potential for improve d quality of palliative treatment compared to existing in-patient trea tments, and it may have a place in shifting care from an in-patient to an out-patient setting in line with recent health care reforms.