IS PACLITAXEL AND CISPLATIN A COST-EFFECTIVE FIRST-LINE THERAPY FOR ADVANCED OVARIAN-CARCINOMA

BACKGROUND. Paclitaxel and cisplatin use for the treatment of advanced ovarian carcinoma (AOC) has been shown to increase median survival du ration. An evaluation was performed on the economic consequences of tr eating AOC patients with combined paclitaxel and cisplatin chemotherap y compared with current usual care, i.e., combined cyclophosphamide an d cisplatin chemotherapy. METHODS. Linear modeling techniques combined with retrospective chart analysis were used to predict the clinical p rogression and treatment of AOC patients until death. Cost-effectivene ss analysis comparing paclitaxel and cisplatin and usual care was perf ormed from a simplified Ministry of Health perspective. RESULTS. Assum ing a 50% increase in survival for paclitaxel and cisplatin patients, an assumption supported by recent clinical trial data, this treatment showed an average lifetime cost per patient of $50,054 Cdn compared wi th a cost of $36,837 Cdn for usual care. The incremental cost of the p aclitaxel and cisplatin treatment over the usual treatment was $20,355 Cdn per life year gained. These results withstood extensive sensitivi ty analyses. CONCLUSIONS. Paclitaxel, in combination with cisplatin, a ppears to be a cost-effective first-line treatment for AOC. A moderate increase in incremental cost compares favorably with other life-savin g strategies currently in use. As more data become available for the u se of paclitaxel, this pilot study will provide a basis for more exten sive economic evaluation of paclitaxel. (C) 1996 American Cancer Socie ty.