Table 4.
Unit costs included in the model
| Cost (SG$) | Range (SG$) | Source | |
|---|---|---|---|
| Cost of drugsa | |||
| Afatinib (per 40 mg tablet)b | 102.95 | 98.80 to 104.29 | [f] |
| Pemetrexed (per 500 mg vial)b | 440.54 | 327.80 to 562.30 | [f] |
| Cisplatin (per 50 mg vial)b | 15.61 | 12.45 to 18.50 | [f] |
| Cost of chemotherapy administration | |||
| Facility fee/chair time (2 to 4 h)c | 272.20 | 241.00 to 319.00 | [f] |
| Chemotherapy preparation fee by pharmacy | 52.80 | 12.00 to 80.00 | [f] |
| Cost of consultation visit and monitoring | |||
| Consultation visit | 74.57 | 93.00 to 102.72 | [f] |
| Computerised tomography-thorax scan | 940.00 | 850.00 to 1000.00 | [f] |
| Liver function test | 71.30 | 52.40 to 83.90 | [f] |
| Full blood count test | 26.46 | 24.00 to 28.10 | [f] |
| Renal panel test | 62.80 | 35.20 to 81.20 | [f] |
| Cost of best supportive care (BSC) | |||
| Inpatient hospice stay (per day) | 275.00 | – | [g] |
| Home hospice visit | Nild | – | [g] |
| Cost of managing adverse event | |||
| Anaemia (per episode)e | 1486.00 | – | [h] |
| Diarrhoea (per episode)e | 1382.40 | – | [h] |
aCost of drug is based on the selling price to patient
bDosing regimens were based on recommended dosages in package inserts for afatinib (40 mg/day), pemetrexed (500 mg/m2/cycle) and cisplatin (75 mg/m2/cycle) and assumed no vial sharing. Up to 6 cycles of chemotherapy, every 21 days, were allowed. An average Body Surface Area (BSA) of 1.6m2 was assumed
cChair time for chemotherapy is approximately 2 h and 40 min. Pemetrexed is infused over 10 min, followed by 30 min break before infusion of cisplatin over 2 h approximately
dHome hospice visit is complementary from the hospice centre
eIncluded hospital admission charges and treatment cost
Source: f weighted average selling price across public healthcare institutions in Singapore; g price charged by one hospice centre in Singapore; h inpatient bill sizes [18, 19]