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Cost-effectiveness analysis of sensitive relapsed small-cell lung cancer based on JCOG0605 trial

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Abstract

Purpose

Since combined strategy with cisplatin, etoposide, and irinotecan has shown the superiority to topotecan alone as second-line chemotherapy in patients with sensitive relapsed small-cell lung cancer, this study aimed to compare these two treatments based on JCOG0605 trail from Chinese cost-effectiveness perspective.

Methods

Basic medical information was derived from a multicenter, open-label, randomized phase III trial (JCOG0605). A Markov model including three health states: progression-free state, progressive disease (PD), and death, was developed to simulate the process of sensitive relapsed small-cell lung cancer. Cost was calculated from the perspective of Chinese society. Sensitivity analyses were applied to explore the impact of essential variables.

Results

Treatment with combination chemotherapy was estimated to increase costs by $6947.32 compared with topotecan alone, with a gain of 0.26 quality-adjusted life years (QALYs). Thus, the incremental cost-effective ratio was $26720.46/QALY for combination treatment versus monotherapy, which was beyond the threshold of 3 × the per capita GDP of China, $24423.00. The costs of PD state were the most influential factors to the model.

Conclusion

The combination chemotherapy with cisplatin, etoposide, and irinotecan was not a cost-effectiveness choice for patients with sensitive relapsed SCLC in China from the cost-effectiveness perspective.

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Authors and Affiliations

  1. State Key Laboratory of Biotherapy, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China

    K. Zhou, F. Wen, P. Zhang, J. Zhou & Q. Li

  2. West China Bio-Medical Big Data Center, Sichuan University, Chengdu, China

    K. Zhou, F. Wen, P. Zhang, J. Zhou, L. Sun & Q. Li

  3. Department of Clinical Pharmacy, West China Hospital, Sichuan University, Chengdu, China

    H. Zheng

  4. Department of Medical Insurance Office, West China Hospital, Sichuan University, Chengdu, China

    L. Sun

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  1. K. Zhou
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  4. J. Zhou
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Correspondence to L. Sun or Q. Li.

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Conflict of interest

Author Kexun Zhou, Author Feng Wen, Author Pengfei Zhang, Author Jing Zhou, Author Hanrui Zheng, Author Lin Sun, and Author Qiu Li declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Research Ethics Committees of West China Hospital, Sichuan University) and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent or substitute for it was obtained from all patients for being included in the study.

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Zhou, K., Wen, F., Zhang, P. et al. Cost-effectiveness analysis of sensitive relapsed small-cell lung cancer based on JCOG0605 trial. Clin Transl Oncol 20, 768–774 (2018). https://doi.org/10.1007/s12094-017-1787-y

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  • DOI: https://doi.org/10.1007/s12094-017-1787-y

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