Journal of Clinical Oncology, Vol 15, 640-645, Copyright © 1997 by American Society of Clinical Oncology
Analysis of the cost-effectiveness of paclitaxel as alternative combination therapy for advanced ovarian cancer
W McGuire, AI Neugut, S Arikian, J Doyle and CM Dezii
Center for Health Outcomes and Economics, East Brunswick, NJ 08816, USA.
PURPOSE: A phase III trial by the Gynecologic Oncology Group (GOG) provides
strong evidence that a new alternative therapy--paclitaxel (Taxol;
Bristol-Myers Squibb Co, Princeton, NJ) in combination with cisplatin
(Platinol; Bristol-Myers Squibb Co)--is clinically more effective than the
standard therapy using cyclophosphamide (Cytoxan; Bristol-Myers Squibb Co)
in combination with cisplatin in the treatment of advanced ovarian cancer.
We conducted a pharmacoeconomic analysis to determine whether the
alternative paclitaxel-cisplatin (TP) therapy is cost-effective (CE) in
comparison to standard cyclophosphamide- cisplatin (CP) therapy. METHODS:
Using an economic model, we applied cost data figures to resource
utilization data derived from the two arms of the GOG trial. We examined
paclitaxel benefits in terms of increased mean survival time, as well as
median survival time. Estimates of the cumulative proportion surviving in
the trial were based on Kaplan-Meier procedures. RESULTS: Per year of life
gained (YLG), TP therapy costs more ($19,820 more for inpatient treatment;
$21,222 outpatient) than CP treatment. CONCLUSION: The TP regimen's
increased mean survival cost per YLG (inpatient and outpatient settings)
adds a substantial benefit at an acceptable cost compared with CP therapy.
