COST-ANALYSIS OF HOSPITAL TREATMENT - 2 CHEMOTHERAPIC REGIMENS FOR NONSURGICAL NON-SMALL-CELL LUNG-CANCER

Study objectives: compare the costs of two regimens of chemotherapy. A pply weighted costs to an economic model in a hospital perspective, De sign: prospective randomized study of two groups of patients receiving : branch B, mitomycin-navelbine-cisplatin (MNP); branch A, mitomycin-v indesine-cisplatin (MVP). Setting: pneumologic units of University and non-University hospitals. Methods: clinical evaluation during chemoth erapy incorporated events enabling construction of an event tree. Dire ct hospital costs included those of: cytostatic agents, materials used and nursing time; costs of side-effects (medical and paramedical time , diagnostic and therapeutic examinations). Effectiveness was measured in terms of response rates. Patients: 209 patients were included, 100 in arm B, 109 in arm A. Results: the response rates were 25% in branc h B, 17% in branch A. In the hypothesis of equivalence of the two stra tegies, we compared only overall mean cost per patient. Despite the fa ct arm B needed more hospital injections, the difference was low (+4.6 %). For a difference in effectiveness, the opposite was observed for t he average cost-effectiveness ratio: arm B was less costly (-12 339.40 FF for a responder). Conclusion: incorporation of economic parameters was found to have a bearing on the choice of chemotherapeutic regimen for the treatment of nonsmall cell lung cancer. Economic analyses of this kind can provide useful extra information for rational therapeuti c decisions.