Objectives: Erlotinib, a representative of targeted therapy, has been approved by FDA for first-line therapy in EGFR-mutations positive NSCLC. However the high price of drug created a large barrier in practice especially in Vietnam. The aim of this study is to estimate the cost-utility of erlotinib versus the standard chemotherapy as firstline therapy in advanced EGFR mutation-positive NSCLC in Vietnam. MethOds: A 3-state Markov model was developed to evaluate the cost-utility of erlotinib versus the standard chemotherapy over life-time horizon. The discount rate of 3% has been evaluated for both cost and QALY. One-way sensitivity analysis was performed to evaluate uncertainties of parameters. Results: Compared with standard therapy, erlotinib regimen in first-line therapy in EGFR-mutations positive NSCLC resulted in the increase of 439.02 million VND treatment cost (534.16 million and 95.14 million VND, respectively) with the increase of 0,11 QALY (1.38 vs 1.27, respectively). The ICUR of erlotinib versus standard chemotherapy was 4.1 billion VND/QALY, which is 34 times higher than the willingness-to-pay of Vietnam (around 120 million VND). One-way sensitivity analysis showed such influencing factors on ICUR as drug price, price of medical services, discount rate, from which price of erlotinib was the most influencing factor. cOnclusiOns: Erlotinib was not cost-effective compared with standard chemotherapy in first-line therapy in EGFR-mutations positive NSCLC.
period evaluated, admissions of elderly (older than 60 years) were the most frequent, accounting for 74% of the total. In addition, men were the majority, with 2.38 times more admissions for men than women. There were 4,311 deaths for the period. The total admissions cost was 120,108,156 BRL. There has also been an annual growth trend in total costs with hospital admissions. Mean cost per admission was 1,990 BRL over the four year period. ConClusions: These results suggest an increasing impact of urothelial carcinoma on SUS admissions costs, especially affecting older men. This pathology has high morbidity and mortality rates if not treated optimally, and investigational immunotherapies that train the immune system to recognize cancer cells may improve outcomes for these patients.
A227treatments; a tendency to lower values was observed with Tocilizumab. At the time of the last evaluation 56% of patients were in remission, 21% had mild activity, 19% had moderate activity and 5% severe activity. All patients with severe activity suspended treatment, and 16% of patients with moderate activity did. Average treatment time 3.7 years. ConClusions: Treatment of RA with biological therapy in CCSS has been effective in a majority of patients, without differences between therapies with a tendency to better response with Tocilizumab that should be evaluated in a future.
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