Economic evaluation of docetaxel/gemcitabine versus docetaxel as frontline treatment of patients with advanced/metastatic non-small cell lung cancer in Greece

SummaryObjectivesThe combination of docetaxel/gemcitabine is an acceptable chemotherapy regimen for the treatment of non-small cell lung cancer. An economic evaluation is undertaken alongside a multi-centre randomized phase III trial, which compares docetaxel/gemcitabine combination with docetaxel monotherapy, in untreated patients with advanced/metastatic non-small cell lung cancer.MethodsTrial resource utilisation data are combined with unit price data used to evaluate the cost of chemotherapy, concomitant medications, hospitalisations, diagnostic and laboratory tests and second-line chemotherapy. Treatment cost is combined with survival to estimate the incremental cost per-life-year-saved with the combination therapy versus monotherapy. To deal with uncertainty, stochastic analysis is used to plot cost–effectiveness acceptability curves.ResultsMedian survival is 9.1 months (range 1–36.2) and 8.3 months (range 1–26.8) (p: 0.025) in the combination and monotherapy groups, respectively. The mean total treatment cost of patients with docetaxel is estimated at €5736 and with docetaxel/gemcitabine at €7417, a difference of €1542 (95%CI: €499–2561). The incremental cost per-life-year-saved of the combination therapy is €9538 and the probability to be cost–effective is 91% at a threshold of €20,000, 97% at a threshold of €35,000 and 98% at a threshold of €50,000.ConclusionsThe data support that docetaxel/gemcitabine combination represents a cost–effective treatment option in relation to docetaxel monotherapy for patients with non-small cell lung cancer in the Greek NHS setting.