COST-EFFECTIVENESS OF NEOADJUVANT MULTIMODAL THERAPY IN PATIENTS WITHESOPHAGEAL ADENOCARCINOMA

We conducted an incremental cost-effectiveness analysis to evaluate an adjuvant multimodal therapy (chemotherapy + radiotherapy) in patients with esophageal adenocarcinoma undergoing surgery. We utilized the cl inical data of a published controlled trial comparing preoperative che motherapy + radiotherapy versus surgery alone. Information on costs wa s derived from local data and verified against reported values. Multim odal treatment was found to improve life expectancy by 196.9 discounte d years every 100 subjects (survival gain of about 2 years per patient ). Costs of this neoadjuvant therapy were estimated as $780,010 per 10 0 patients. Our cost-effectiveness analysis showed that the cost per l ife year gained was $3,961 for the multimodal therapy in comparison wi th surgery alone. The pharmacoeconomic profile of this therapeutic mod ality compares favorably with previous economic data calculated for ot her types of health care intervention.