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Comparative Cost-Effectiveness of Paclitaxel-Cisplatin (TP) vs Cyclophosphamide-Cisplatin (CP) in Women with Advanced Epithelial Ovarian Cancer: Results from a Randomized Trial

Ivor Benjamin, MD
OncoLink Assistant Editor
Ultima Vez Modificado: 21 de mayo del 2000

Presenter: Hugh Walker
Affiliation: Queens Univ. and Tom Baker Cancer Ctr, Canada

Background:
This sub-analysis of 160 patients in the intergroup trial (EORTC-GCCG, NOCOVA, NCIC-CTG, SGCSG) compares the cost effectiveness of paclitaxel (Taxol) - cisplatin (TP) vs. cyclophosfamide-cisplatin in the treatment of epithelial ovarian cancer.

Materials and Methods:

• 160 of 680 patients originally randomized to receive TP vs. CP were analyzed for cost comparison.
• The study group were the patients randomized by the NCIC-CTG in the original trial.
• Cost-effectiveness (CE) defined as incremental cost per incremental life-year gained) based on median overall survival in Canadian patients.

• CE was $13,135 (US Dollars) for TP vs. CP
• The gross cost per progression-free life year gained on the TP arm was $21,321

• CE for the gain in overall survival from TP is well below the commonly cited threshold for cost-effective care of $50,000 per incremental life-year of overall survival.
• TP has acceptable CE in the treatment of epithelial ovarian cancer

• When compared with other life-extending therapies (e.g. renal dialysis) TP is cost effective
• Oncologists treating ovarian cancer patients with TP may wish to cite this study if their patients are denied reimbursement by health insurance providers.