ANALYSIS OF THE COST-EFFECTIVENESS OF PACLITAXEL AS ALTERNATIVE COMBINATION THERAPY FOR ADVANCED OVARIAN-CANCER

Purpose: A phase III trial by the Gynecologic Oncology Group (GOG) pro vides strong evidence that a new alternative therapy-paclitaxel (Taxol ; Bristol-Myers Squibb Co, Princeton, NJ) in combination with cisplati n (Platinol; Bristol-Myers Squibb Co) - is clinically more effective t han the standard therapy using cyclophosphamide (Cytoxan; Bristol-Myer s Squibb Co) in combination with cisplatin in the treatment of advance d ovarian cancer. We conducted a pharmacoeconomic analysis to determin e whether the alternative paclitaxel--cisplatin (TP) therapy is cost-e ffective (CE) in comparison to standard cyclophosphamide-cisplatin (CP ) therapy. Methods: Using an economic model, we applied cost data figu res to resource utilization data derived from the two arms of the GOG trial. We examined paclitaxel benefits in terms of increased mean surv ival time, as well as median survival time. Estimates of the cumulativ e proportion surviving in the trial were based on Kaplan-Meier procedu res. Results: Per year of life gained (YLG), TP therapy costs more ($1 9,820 more far inpatient treatment; &21,222 outpatient) than CP treatm ent. Conclusion: The TP regimen's increased mean survival cost per YLG (inpatient and outpatient settings) adds a substantial benefit at an acceptable cost compared with CP therapy. (C) 1997 by American Society of Clinical Oncology.