Table 8.
Comparison in cost-effectiveness of direct medical cost between pemetrexed and other maintenance therapy: study designs and results
| Reference | Methods, costs and outcomes discount, study perspective, time frame and reference year for cost | Data sources | Study population | Regime | Costs | LYG / OS | QALY | ICER / LYG | ICER / QALY |
|---|---|---|---|---|---|---|---|---|---|
| Klein et al20 (US) |
See Klein et al20 | PEM | |||||||
| Non-SQ | $96,774 | 1.3412 Y | ND | ||||||
| All NSCLC | $89,289 | 1.2434 Y | ND | ||||||
| Erlotinib | |||||||||
| Incremental PEM to Erlotinib | |||||||||
| Non-SQ | $72,300 | 1.1784 Y | ND | $ 150,260 | ND | ||||
| All NSCLC | $71,147 | 1.1854 Y | ND | $ 312,341 | ND | ||||
| Bev (15 mg/kg) | |||||||||
| Incremental Bev to PEM | |||||||||
| Non-SQ | $105,961 | 1.2933 Y | ND | Dominated | ND | ||||
| Dickson et al27 (UK) |
ERG report reviewing the manufacturer’s evidence submission, de novo economic model Cost discount; ND Time frame; lifetime Reference year; ND |
Clinical parameters: RCT (SATURN, JMEN trial) | Model 1; SD, All NSCLC: Erl vs. placebo Model 2; SD, SQ: Erl vs. placebo Model 3; SD, non-SQ: Erl vs. PEM |
PEM | |||||
| SD, non-SQ | £26,608 | 1.5495 Y | 0.9229 | ND | ND | ||||
| Erlotinib | |||||||||
| Incremental PEM to Erlotinib | |||||||||
| SD, non-SQ | £18,148 | 1.4213 Y | 0.8222 | ND | £84,029 | ||||
| Nuijten et al28 (France, Germany, Italy and Spain) |
Cross-market cost comparison Perspective of national health-care decision-makers or purchasers. Time frame; monthly Reference; 2008 Euro |
Clinical parameters: RCT (SATURN, JMEN trial) Cost; literatures, National drug tariffs for France, Germany, Italy and Spain |
Advanced NSCLC | PEM | ND | ND | ND | ND | |
| France | €3,453 | ||||||||
| Germany | €5,534 | ||||||||
| Italy | €2,921 | ||||||||
| Spain | €3,164 | ||||||||
| Erlotinib | ND | ND | ND | ND | |||||
| France | €2,140 | ||||||||
| Germany | €2,732 | ||||||||
| Italy | €1,518 | ||||||||
| Spain | €2,048 | ||||||||
Abbreviations: Bev, bevacizumab; Erl, erlotinib; ERG, Evidence Review Group; ICER, incremental cost-effectiveness ratio; LYG, life-year gained; ND, not described; NSCLC, non-small-ell lung cancer; OS, overall survival; PEM, pemetrexed; QALY, quality-adjusted life-year; RCT; randomized controlled trial; SD, stable disease; SQ, squamous cell carcinoma; Y, years.