The incremental cost-effectiveness ratio of cetuximab over best supportive care alone in unselected advanced colorectal cancer patients is high and sensitive to drug cost. Incremental cost-effectiveness ratios were lower when the analysis was limited to patients with wild-type KRAS tumors.

With an incremental cost-effectiveness ratio of $94 638 per life-year gained, erlotinib treatment for patients with previously treated advanced non-small cell lung cancer is marginally cost-effective. The use of molecular predictors of benefit for targeted agents may help identify more or less cost-effective subgroups for treatment.

Introduction:Cancer clinical trials frequently incorporate quality of life (QoL) measures but rarely patient utility. Utility information is required for cost utility evaluations of novel cancer therapies. We assessed the feasibility of converting QoL data into utility scores using the European Organization for Research and Treatment of Cancer Quality of Life-Core 30 questionnaire (EORTC QLQ-C30) and the EQ-5D in patients with non-small cell lung cancer (NSCLC). Methods: Outpatients with all different disease states of NSCLC attending a major Canadian cancer center completed the QLQ-C30 and EQ5D on a single visit. Results of the QLQ-C30 summary scores were mapped to predict EQ-5D utility scores using linear regression. Backward variable elimination using the Akaike Information Criterion was used to reduce the full model that included all QLQ-C30 summary scores to examine which QLQ-C30 dimensions best predict a patient's utility score. To test the predictive power of the model, 10-fold cross-validation was used. Results: A total of 172 patients participated in the study. Median age of the sample was 66 years (range, 32-85 years); 46.5% were men. The cross-validation estimate of mean utility score was 0.76 (SD: 0.20), which was the same as the actual mean utility score. Of the 15 QLQ-C30 dimensions, 4 functional dimensions (physical, role, emotional, and social) and the pain symptom dimension were predictive of patient utility scores. Conclusions:Our study demonstrates the feasibility of deriving utility scores from prospective QoL data. Validation of the QLQ-C30 predictors found in this study could further the ability to estimate cost utility of therapies for economic evaluations.

Primary prophylaxis against febrile neutropenia with either filgrastim or pegfilgrastim is not cost-effective in DLBCL patients.

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Objective: To determine utilization and costs of home care services (HCS) for individuals with a diagnosis of breast cancer (BC). Methods: Incident cases of invasive BC in women were extracted from the Ontario Cancer Registry (2005–2009) and linked with other Ontario health care administrative databases. Control patients were selected from the population of women never diagnosed with any type of cancer. The types and proportions of HCS used were determined and stratified by disease stage. Attributable home care utilization and costs for BC patients were determined. Factors associated with HCS costs were assessed using regression analysis. Results: Among the 39,656 BC and 198,280 control patients identified (median age: 61.6 years for both), 75.4% of BC patients used HCS (62.1% stage I; 85.7% stage II; 94.6% stage III; 79.1% stage IV) compared with 14.6% of control patients. The number of HCS used per patient–year were significantly higher for the BC patients than for the control patients (14.97 vs. 6.13, p < 0.01), resulting in higher costs per patient–year ($1,210 vs. $325; $885 attributable cost to BC, p < 0.01). The number of HCS utilized and the associated costs increased as the BC stage increased. In contrast, HCS costs decreased as income increased and as previous health care exposure decreased. Interpretation: Patients with BC used twice as many HCS, resulting in costs that were almost 4 times those observed in a matched control group. Less than an additional $1000 per BC patient per year were spent on HCS utilization in the study population.

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