To determine the potential economic and policy implications that result from incorporating paclitaxel into first-line therapy for stage 3 and 4 ovarian cancer patients in the province of Ontario, Canada.
A cost-effectiveness analysis was conducted to compare cisplatin/cyclophosphamide (CC), a standard therapy, with cisplatin/paclitaxel (CT).
Based on survival curves from a clinical trial, mean costs and survival were calculated.
Sensitivity analyses were conducted based on altering the duration of paclitaxel infusion, discount rates, and efficacy of paclitaxel.
The mean survival duration is prolonged from 2.06 years with the standard therapy to 2.44 years with the paclitaxel combination.
The paclitaxel therapy is more expensive, with a mean cost of $17,469 (Canadian) per patient treated with CT compared with $5,228 per patient with CC.
The incremental cost-effectiveness ratio is $32,213 per year gained.
Sensitivity analyses show that the conclusions remain unchanged.
The use of CT as first-line treatment for advanced ovarian cancer patients in Ontario requires an additional $9 million per year over and above the present costs to treat this patient population.
Although paclitaxel-based therapy prolongs survival, it comes at an increased cost.
It may not be possible to fund paclitaxel treatment using resources presently allocated to first-line chemotherapy for advanced ovarian cancer. (...)
Mots-clés Pascal : Carcinome, Ovaire, Paclitaxel, Chimiothérapie, Traitement, Cyclophosphamide, Cisplatine, Association médicamenteuse, Analyse coût efficacité, Aspect économique, Etude comparative, Ontario, Canada, Amérique du Nord, Amérique, Homme, Femelle, Stade avancé, Anticancéreux, Tumeur maligne, Appareil génital femelle pathologie, Ovaire pathologie, Taxane dérivé, Moutarde à l'azote, Oxazaphosphinane dérivé, Platine II Complexe, Economie santé
Mots-clés Pascal anglais : Carcinoma, Ovary, Paclitaxel, Chemotherapy, Treatment, Cyclophosphamide, Cisplatin, Drug combination, Cost efficiency analysis, Economic aspect, Comparative study, Ontario, Canada, North America, America, Human, Female, Advanced stage, Antineoplastic agent, Malignant tumor, Female genital diseases, Ovarian diseases, Taxane derivatives, Nitrogen mustard, Oxazaphosphinane derivatives, Platinum II Complexes, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0186171
Code Inist : 002B02R02. Création : 21/05/1997.