geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Cost-effectiveness of vinorelbine alone or vinorelbine plus cisplatin for stage IV NSCLC


, : Cost-effectiveness of vinorelbine alone or vinorelbine plus cisplatin for stage IV NSCLC. Oncology 12(3 Suppl 4): 18-25; Discussion 25-6

Le Chevalier and colleagues have reported results of a randomized controlled clinical trial comparing vinorelbine alone, versus vinorelbine combined with cisplatin, versus standard treatment consisting of vindesine and cisplatin in the treatment of patients with advanced non-small-cell lung cancer (NSCLC). Data on survival in the three study arms and estimates of the resources used to treat these patients were extracted from the publication and inserted into Statistics Canada's POpulation HEalth Model (POHEM). This model includes data on diagnostic methods, treatment, and outcomes appropriate for stage at presentation, health care utilization, and direct care costs ($ Canadian) for best supportive care and for several "standard" chemotherapy regimens used to treat advanced NSCLC. POHEM was then used to model the cost of care per patient and the total burden of cost on the Canadian health care system for each of the chemotherapy treatment strategies and for best supportive care. Based on the published survival curves for each of the vinorelbine regimens, it was possible to estimate the survival gain relative to the standard chemotherapy regimens and to best supportive care, and to estimate their cost-effectiveness as cost per life year gained. Based on this analysis, the most cost-effective standard regimen relative to best supportive care was vinblastine/cisplatin, as it increased average survival while reducing costs by $2,846 per case. Vinorelbine/cisplatin increased survival to a greater degree, but inpatient administration costs associated with the delivery of cisplatin increased treatment costs by $2,983 per case and resulted in a cost-effectiveness ratio of $6,386 per life year gained. As high-dose cisplatin is not routinely administered in the inpatient setting in Canadian institutions, estimates were made of the cost of outpatient administration. The cost of outpatient care was $55 less per case demonstrating that this is the most cost-effective way to administer the regimen. Relative to etoposide/cisplatin and vinblastine/cisplatin, outpatient vinorelbine/cisplatin proved to be cost-effective. Various chemotherapy regimens used in the management of advanced NSCLC all fall within the boundaries of cost-effectiveness generally accepted for health care interventions in Canada. Therefore, cost and cost-effectiveness should not be barriers to the utilization of vinorelbine/cisplatin in Canada.

US$29.90

PMID: 9556779


Other references

Vakarchuk G.I.; Lukin A.B.; Paliy A.M.; Tkachishin S.V., 1978: Lower Vizean clastic sediments of the northwest part of the Dnieper-Donets depression; a new commercially oil-gas-bearing complex. Petroleum Geology 15(8): 344-346

Sindelar, B.W.; Montagne, C.; Kroos, R.R.H., 1995: Holistic resource management: an approach to sustainable agriculture on Montana's Great Plains. The concept of 'Holistic Resource Management' (HRM), and its application to sustainable agriculture, are discussed. HRM considers the whole ecosystem, and emphasizes thorough analysis of potential tools and actions before their use. Four...

Forstner J.F.; Jabbal I.; Findlay B.P.; Forstner G.G., 1977: Interaction of mucins with calcium hydrogen ion and albumin. Forstner, G G (Ed ) Modern Problems in Pediatrics, Vol 19 Mucus Secretions And Cystic Fibrosis Canadian Cystic Fibrosis Conference, Kimberley, Ont , Canada, Oct 24-27, 1976 Viii+217p Illus S Karger: Basel, Switzerland; New York, N Y , Usa Isbn 3-8055-2678-4 54-65

Mullamitha, S.A.; Ton, N.C.; Parker, G.J.M.; Jackson, A.; Julyan, P.J.; Roberts, C.; Buonaccorsi, G.A.; Watson, Y.; Davies, K.; Cheung, S.; Hope, L.; Valle, J.W.; Radford, J.A.; Lawrance, J.; Saunders, M.P.; Munteanu, M.C.; Nakada, M.T.; Nemeth, J.A.; Davis, H.M.; Jiao, Q.; Prabhakar, U.; Lang, Z.; Corringham, R.E.; Beckman, R.A.; Jayson, G.C., 2007: Phase I evaluation of a fully human anti-alphav integrin monoclonal antibody (CNTO 95) in patients with advanced solid tumors. A fully human monoclonal antibody to anti-alpha(v) integrins (CNTO 95) has been shown to inhibit angiogenesis and tumor growth in preclinical studies. We assessed the safety and pharmacokinetics of CNTO 95 in patients with advanced refractory soli...

Collis, S.J.; Khater, K.; DeWeese, T.L., 2003: Novel therapeutic strategies in prostate cancer management using gene therapy in combination with radiation therapy. Prostate brachytherapy with permanent radioactive implants is becoming an increasingly popular treatment choice for patients with prostate cancer. This therapy is attractive to patients due to the fact that it is an outpatient procedure and in man...

González-Cruz, B.J.; Rodríguez-Labastida, M.; González-Cortázar, M.; Zamilpa, A.; López-Arellano, M.E.; Aguilar-Marcelino, L.; González-Garduño, R.; Torres-Acosta, J.F.J.; Olmedo-Juárez, A.; Mendoza-de Gives, P., 2017: In vitro larvicidal and in vivo anthelmintic effects of Oxalis tetraphylla (Oxalidaceae) hydroalcoholic extract against Haemonchus contortus in lambs. The in vitro larvicidal and in vivo anthelmintic effects of Oxalis tetraphylla hydroalcoholic extract (HE), against Haemonchus contortus in experimentally infected lambs, were assessed. We used a microtitration plate method, comprising the followi...

Gawel Adam; Olkiewicz Stanislaw; Zabinski Witold, 1997: XRD and IR spectroscopic investigations of some chrysoprases. Mineralogia Polonica: , Pages 43-51. 1997.

Waters, W.J.; Adams, J.E.; Kelley, B.C.; Rosenberg, W.H.; Stern, T.D., 1977: Health perspectives in Rhode Island: a sample survey. Rhode Island Medical Journal 60(12): 583-587

D.C.staing; F.P.rdigao Cotta; C.S.lloum, 2011: Conducta general en las hepatectomías por laparotomía. Al hacer una hepatectom a deben respetarse tres reglas: adaptar la ex resis a la lesi n y no al cirujano, evitar las complicaciones t cnicas de la hepatectom a (hemorragia, p rdida biliar y necrosis del par nquima restante) y dejar suficiente par...

Tarbaev M.B. (Tarbayev M.B), 1994: Gold from Prepolar Ural deposits of different formation types. Abstracts of the