The cost-effectiveness of paclitaxel (Taxol (R)) plus cisplatin is similarto that of teniposide plus cisplatin in advanced non-small cell lung cancer: a multicountry analysis

A large randomized clinical trial in advanced, previously untreated, non-sm all cell lung cancer (NSCLC) patients revealed better response rates and be tter tolerance for paclitaxel+cisplatin (TAXCIS) compared to teniposide+cis platin (TENCIS). Since economic evidence is receiving increasing attention in health care, we conducted;an economic evaluation based on the trial resu lts in The Netherlands, Belgium, France and Spain. The evaluation was based on (i) differences in drug costs, (ii) differences in chemotherapy adminis tration and (iii) the economic consequences of significantly different clin ical outcomes in the trial: anemia, thrombocytopenia, neutropenia, neuropat hy and arthralgia/myalgia. Data regarding medical resource utilization were obtained from clinician interviews using a Delphi technique and validated by patient charts analysis. Differences in medical management occurred acro ss countries, but TAXCIS was cost-additive in all countries, i.e. the extra cost of chemotherapy was only partially compensated by savings in medical resource use, resulting in a net cost per patient of US$2311. In the trial, TAXCIS therapy produced a 37% response rate compared to 26% for TENCIS. Th e cast per extra responder for TAXCIS is on average US$21011, which is comp arable to the cost per responder obtained with TENCIS (US$27266). Thus, the cost-effectiveness of TAXCIS, expressed in cost per responder, is similar to the cost-effectiveness obtained with TENCIS. [(C) 1999 Lippincott Willia ms & Wilkins.].