Real-world cost-effectiveness analysis of second-line pemetrexed versus docetaxel in the Ontario nonsmall- cell lung cancer population
Year: 2015
Type: dissertation
Study design: Observational Study
Abstract: Docetaxel is a standard treatment for advanced non-small-cell lung cancer in Ontario after first-line platinum-based therapy. In 2008, pemetrexed was approved for funding in the second-line setting based on evidence of equal efficacy as docetaxel, with an improved toxicity profile at a higher cost. Net benefit regression was used to determine the cost-effectiveness of pemetrexed compared to docetaxel in the Ontario population using data from health administrative databases. Overall survival was not significantly different in those treated with pemetrexed compared to docetaxel; however, those treated with docetaxel had higher chemotherapy-related toxicities requiring inpatient hospitalization. The incremental net benefit for pemetrexed was -$8611-20,279 for WTP values ranging from $0-150,000/QALY, suggesting that pemetrexed was not cost-effective at the listed drug price. The probability of cost-effectiveness was 40.9% for a 50% price reduction of pemetrexed at a WTP value of $0/QALY gained, for price reductions of 10-50% and WTP values of $0-300,000/QALY gained.
Source: TSpace (University of Toronto)
Author: Dolly Han
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2527868722