To evaluate the cost-effectiveness (CE) of new combined modality strategies in patients with stage III non-small-cell lung cancer (NSCLC).
Recent studies suggest that combined modality therapy confers a survival advantage for patients with stage III NSCLC.
Using the Statistics Canada (Ottawa, Canada) lung cancer costing model, we have evaluated the CE of these interventions using 1993 Canadian health care costs and the perspective of the government as payer in a universal health care system.
We estimate that the cost to treat a stage IIIa NSCLC patient with preoperative and postoperative chemotherapy would increase by $15,886, and a similar combined modality approach with the addition of postoperative radiotherapy would increase the cost by $22,963.
Chemoradiotherapy for stage IIIb NSCLC would produce a smaller incremental cost of approximately $8,912 per case.
However, these approaches are remarkably cost-effective, with cost per life-year gained (LYG) ranging from $3,348 to $14,958.
Administering all chemotherapy in the outpatient department would improve CE.
For sensitivity analysis, we reduced the survival gain that resulted from the three interventions by 25% and 50%, and increased the hospital per diem rates by 10%, 20%, and 30%. Conclusion : Even with the most adverse assumptions, the CE estimates were all considered acceptable for new health care technologies in Canada. (...)
Mots-clés Pascal : Carcinome non petite cellule, Bronchopulmonaire, Homme, Traitement associé, Chimiothérapie, Chirurgie, Radiothérapie, Hospitalisation, Analyse coût efficacité, Economie santé, Canada, Amérique du Nord, Amérique, Stade avancé, Appareil respiratoire pathologie, Poumon pathologie, Bronche pathologie, Tumeur maligne
Mots-clés Pascal anglais : Non small cell carcinoma, Bronchopulmonary, Human, Combined treatment, Chemotherapy, Surgery, Radiotherapy, Hospitalization, Cost efficiency analysis, Health economy, Canada, North America, America, Advanced stage, Respiratory disease, Lung disease, Bronchus disease, Malignant tumor
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0472202
Code Inist : 002B11A. Création : 03/02/1998.