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- W2519284057 abstract "Erlotinib, an EGFR tyrosine kinase inhibitor, is a new second-line therapeutic option for patients with NSCLC. Erlotinib has been shown to achieve comparable improvement in overall survival, but with a more favourable side effect profile than standard chemotherapy regimens. Another advantage of this agent is the use of oral administration. The favourable tolerability profile of erlotinib may be beneficial to the patients’ quality of life, and may lead to cost-savings for the health care system. The objective of this study was to evaluate the costs of treatment per patient in Germany for erlotinib, docetaxel and pemetrexed, taking into account the costs of managing adverse events (AEs). The treatment regimens considered were continuous daily dosing with erlotinib (150mg/day, p.o.), and a 21-day cycle of docetaxel (75mg/m2 i.v.) or pemetrexed (500mg/m2 i.v.). Base costs and total costs per patient per quarter were calculated for the three regimens. The base costs comprised the outpatient costs for medical surveillance, drugs and drug administration, disregarding the costs of managing AEs. Costs of co-medications (dexamethasone for patients treated with docetaxel; dexamethasone, folic acid and vitamin B12 for patients treated with pemetrexed) were also considered. Total costs included the base costs plus, for each regimen, the average cost per patient of treating AEs in outpatient and inpatient facilities (only grade 3/4 AEs (NCIC-CTC) were considered). Resource utilisation data were obtained from two multinational, randomized phase III trials in patients with advanced relapsed NSCLC (Shepherd et al. NEJM 2005;353:123-32; Hanna et al. J Clin Oncol 2004;22:1589-97). Further required data were estimated from national guidelines and prescribing information for the drugs considered. The analysis was conducted from the perspective of German healthcare funding bodies. Cost data were obtained from published sources for the year 2005. Costs of medical services were derived from EBM 2000plus (the current physicians’ uniform fee scale). Drug costs in the outpatient setting were taken from the IfAP® Index drug price list. For hospital admissions due to AEs, the disease related groups for lung cancer were used. Reflecting the social health insurance (SHI) system, patient co-payments for drugs and hospital treatment, and the legally required discounts from pharmacists and drug manufacturers to the SHI system were both taken into account. The base cost per quarter per patient treated with erlotinib was €8,172, versus €8,055 for docetaxel and €15,870 for pemetrexed. Including the cost of managing AEs, the total quarterly cost per patient on erlotinib was €8,376, versus €9,976 for docetaxel and €16,596 for pemetrexed. Sensitivity analyses indicated that the difference in favour of erlotinib was a robust finding, being maintained across a range of cost conditions. A comparison of total medical care costs per patient shows an overall cost advantage for erlotinib over docetaxel. This may be attributable to the favourable side effect profile of erlotinib, and particularly the lack of haematological toxicity. The overall cost advantage for erlotinib compared with pemetrexed is a consequence of the lower drug costs and lower costs of AE management with erlotinib. The use of erlotinib for second-line therapy of NSCLC has been now shown to have potential health economic benefits for the German healthcare system." @default.
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- W2519284057 date "2007-08-01" @default.
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- W2519284057 title "P3-084: Second-line treatment of Non-Small Cell Lung Cancer (NSCLC) with erlotinib is potentially cost-saving for the German healthcare system" @default.
- W2519284057 doi "https://doi.org/10.1097/01.jto.0000284060.34233.19" @default.
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