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Is paclitaxel and cisplatin a cost‐effective first‐line therapy for advanced ovarian carcinoma?
Author(s) -
Covens Allan,
Boucher Sylvain,
Roche Kathie,
Macdonald Moira,
Pettitt Daniel,
Jolain Bruno,
Souetre Eric,
Rivière Marc
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960515)77:10<2086::aid-cncr18>3.0.co;2-r
Subject(s) - medicine , cisplatin , paclitaxel , oncology , chemotherapy , christian ministry , cost effectiveness , surgery , philosophy , risk analysis (engineering) , theology
BACKGROUND Paclitaxel and cisplatin use for the treatment of advanced ovarian carcinoma (AOC) has been shown to increase median survival duration. An evaluation was performed on the economic consequences of treating AOC patients with combined paclitaxel and cisplatin chemotherapy compared with current usual care, i.e., combined cyclophosphamide and cisplatin chemotherapy. METHODS Linear modeling techniques combined with retrospective chart analysis were used to predict the clinical progression and treatment of AOC patients until death. Cost‐effectiveness analysis comparing paclitaxel and cisplatin and usual care was performed from a simplified Ministry of Health perspective. RESULTS Assuming 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 with a cost of $36,837 Cdn for usual care. The incremental cost of the paclitaxel and cisplatin treatment over the usual treatment was $20,355 Cdn per life year gained. These results withstood extensive sensitivity analyses. CONCLUSIONS Paclitaxel, in combination with cisplatin, appears to be a cost‐effective first‐line treatment for AOC. A moderate increase in incremental cost compares favorably with other life‐saving strategies currently in use. As more data become available for the use of paclitaxel, this pilot study will provide a basis for more extensive economic evaluation of paclitaxel. Cancer 1996;77:2086‐91.