Systematic Overview of Cost-Utility Assessments in Oncology

Earle, Craig C.; Chapman, Richard H.; Baker, C.S.; Bell, Chaim M.; Stone, Patricia W.; Sandberg, Eileen A.; Neumann, Peter J.

doi:10.1200/jco.2000.18.18.3302

Cited by 277 publications

(193 citation statements)

References 60 publications

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“…Incorporation of these parameters may affect the results, especially since both administration and incidence of adverse events differ between the two drugs. A cost -utility analysis would have been more interesting, associating costs and quality of life derived from each therapy, and giving patient preferences for each of the two drugs (Earle et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Cost-minimisation analysis of pegylated liposomal doxorubicin hydrochloride versus topotecan in the treatment of patients with recurrent epithelial ovarian cancer in Spain

Ojeda

Sande²,

Casado

et al. 2003

Br J Cancer

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The study consisted of a cost-minimisation analysis since the findings from a multicentre randomised phase III trial showed that pegylated liposomal doxorubicin hydrochloride was at least as efficacious as topotecan. An economic model from the Spanish hospitals perspective was constructed to compare the costs derived from the treatment using both drugs in patients with recurrent epithelial ovarian cancer who failed a first-line platinum-containing regimen. The cost evaluation included direct medical costs: drug, drug administration and costs of managing adverse events. Estimation of resources used in managing adverse events was made retrospectively through an expert panel. Results obtained per patient were: cost of drug and administration, 8647.70 euros for pegylated liposomal doxorubicin hydrochloride and 8519.94 euros for topotecan, while cost of managing adverse events was 967.02 euros in the pegylated liposomal doxorubicin hydrochloride arm and 3304.75 euros for topotecan. The total cost per patient was therefore estimated to be 9614.72 euros for pegylated liposomal doxorubicin hydrochloride and 11 824.69 euros for topotecan, showing that pegylated liposomal doxorubicin hydrochloride produces a cost saving of 2209.97 euros per patient in comparison to topotecan. Sensitivity analyses verified the robustness of the results. These findings suggest that pegylated liposomal doxorubicin hydrochloride is an efficient therapy and can be used as a cost-saving option for treatment of patients with recurrent epithelial ovarian cancer who have failed a first-line platinum-containing regimen.

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Section: Discussionmentioning

confidence: 99%

Cost-minimisation analysis of pegylated liposomal doxorubicin hydrochloride versus topotecan in the treatment of patients with recurrent epithelial ovarian cancer in Spain

Ojeda

Sande²,

Casado

et al. 2003

Br J Cancer

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“…The cost-effectiveness of AIs is reasonable and similar to other standard treatments for early breast cancer [107][108][109]. Treatments that cost less than $50,000 (or £30,000) per quality-adjusted life-year (QALY) gained are generally considered to be cost-effective [109].…”

Section: Cost-effectivenessmentioning

confidence: 95%

Appraising Adjuvant Aromatase Inhibitor Therapy

Perez

2006

The Oncologist

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Tamoxifen, once the gold standard adjuvant endocrine therapy for early breast cancer, is being challenged by third-generation aromatase inhibitors (AIs) that have demonstrated improved disease-free survival in a variety of adjuvant settings for early breast cancer. Tamoxifen and AIs have different safety profiles, which should allow physicians to begin to individualize treatment based on a patient's comorbidities and risk factors. Because of its properties as a partial estrogen agonist, tamoxifen has a positive effect on serum lipids and may confer a cardioprotective benefit, as well as a beneficial effect on bone health. However, tamoxifen increases the risk for endometrial cancer and cerebrovascular/thromboembolic events. In comparison, the major side effect of AIs is increased bone loss, which may heighten the risk for osteoporotic fractures and bone pain. Because of their superior efficacy and manageable side effects, AIs are a cost-effective alternative to tamoxifen, and clinical guidelines now embrace AIs as appropriate adjuvant therapy for hormone-sensitive early breast cancer. The anticipated results of ongoing trials will provide further insights into the long-term safety and application of AI therapy in the adjuvant setting.

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“…In contrast to other studies using global indicators of health status for QAS analysis (Earle et al, 2000), we specified the frame of individual reference. Patients were asked to imagine they would have to live the rest of their life in their current condition and then to rate their concurrent condition.…”

Section: Quality-adjusted Survivalmentioning

confidence: 99%

“…Experience of breast cancer (Ashby et al, 1994) and adjuvant chemotherapy (Lindley et al, 1998;Jansen et al, 2001b) have been shown to be associated with current preferences. Most often, this type of evaluation is based on cross-sectional comparisons (Earle et al, 2000). A repeated formal utility interview is not feasible in an international phase-III trial and would not imply a priori a better performance than a rating scale such as our SHE indicator (Giesler et al, 1999).…”

Section: Quality-adjusted Survivalmentioning

confidence: 99%

Quantifying trade-offs: quality of life and quality-adjusted survival in a randomised trial of chemotherapy in postmenopausal patients with lymph node-negative breast cancer

et al. 2004

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We evaluated quality of life (QL) and quality-adjusted survival in International Breast Cancer Study Group Trial IX, a randomised trial including 1669 eligible patients receiving tamoxifen for 5 years or three prior cycles of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) followed by 57 months tamoxifen. During the time with CMF toxicity (Tox), without symptoms and toxicity (TWiST), and following relapse (Rel), patients scored their QL indicators and a utility indicator for subjective health estimation between 'perfect' and 'worst' health. Scores were averaged within Tox, TWiST and Rel and transformed to utilities. Mean durations for the three transition times were weighted with utilities to obtain mean quality-adjusted TWiST (Q-TWiST). Patients receiving CMF reported significantly worse scores for most QL domains at month 3, but less hot flushes. After completing chemotherapy, there were no differences by treatment groups. Benefits evaluated by Q-TWiST favoured the additional chemotherapy. CMF provided 3 more months of Q-TWiST for patients with ER-negative tumours, but CMF provided no benefit in Q-TWiST for patients with ERpositive tumours. Q-TWiST analysis based on patient ratings is feasible in large-scale cross-cultural clinical trials.

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Systematic Overview of Cost-Utility Assessments in Oncology

Cited by 277 publications

References 60 publications

Cost-minimisation analysis of pegylated liposomal doxorubicin hydrochloride versus topotecan in the treatment of patients with recurrent epithelial ovarian cancer in Spain

Cost-minimisation analysis of pegylated liposomal doxorubicin hydrochloride versus topotecan in the treatment of patients with recurrent epithelial ovarian cancer in Spain

Appraising Adjuvant Aromatase Inhibitor Therapy

Quantifying trade-offs: quality of life and quality-adjusted survival in a randomised trial of chemotherapy in postmenopausal patients with lymph node-negative breast cancer

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