Vergnenègre A, Perol M, Pham E
Service de Pneumologie, Hôpital Universitaire du Cluzeau, Limoges, France.
Lung Cancer. 1996 Feb;14(1):31-44. doi: 10.1016/0169-5002(95)00511-0.
compare the costs of two regimens of chemotherapy. Apply weighted costs to an economic model in a hospital perspective.
prospective randomized study of two groups of patients receiving: branch B, mitomycin-navelbine-cisplatin (MNP); branch A, mitomycin-vindesine-cisplatin (MVP).
pneumologic units of University and non-University hospitals.
clinical evaluation during chemotherapy incorporated events enabling construction of an event tree. Direct hospital costs included those of: cytostatic agents, materials used and nursing time; costs of side-effects (medical and paramedical time, diagnostic and therapeutic examinations). Effectiveness was measured in terms of response rates.
209 patients were included, 100 in arm B, 109 in arm A.
the response rates were 25% in branch B, 17% in branch A. In the hypothesis of equivalence of the two strategies, we compared only overall mean cost per patient. Despite the fact arm B needed more hospital injections, the difference was low (+4.6%). For a difference in effectiveness, the opposite was observed for the average cost-effectiveness ratio: arm B was less costly (-12 339.40 FF for a responder).
incorporation of economic parameters was found to have a bearing on the choice of chemotherapeutic regimen for the treatment of non-small cell lung cancer. Economic analyses of this kind can provide useful extra information for rational therapeutic decisions.
