Patterns, costs and cost-effectiveness of care in a trial of chemotherapy for advanced non-small cell lung cancer

In a recently published randomised trial of chemotherapy versus palliative care in advanced non-small cell lung cancer (the MIC2 trial), chemotherapy was shown to prolong survival without compromising quality of life. The study presented here examines patterns of care and their associated costs with...

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Bibliographic Details
Published in:Lung cancer (Amsterdam, Netherlands) Netherlands), 2002-08, Vol.37 (2), p.219-225
Main Authors: Billingham, L.J, Bathers, S, Burton, A, Bryan, S, Cullen, M.H
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Combined Chemotherapy Protocols - economics
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Bootstrapping
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - economics
Carcinoma, Non-Small-Cell Lung - pathology
Chemotherapy
Cisplatin - economics
Cisplatin - therapeutic use
Cost
Costs and Cost Analysis
Female
Home Care Services, Hospital-Based - economics
Hospital Costs
Hospitalization - economics
Humans
Ifosfamide - economics
Ifosfamide - therapeutic use
Length of Stay
Lung Neoplasms - drug therapy
Lung Neoplasms - economics
Lung Neoplasms - pathology
Male
Medical sciences
Middle Aged
Mitomycin - economics
Mitomycin - therapeutic use
Non-small cell lung cancer
Palliative Care - economics
Pneumology
Prospective Studies
Retrospective Studies
Sensitivity and Specificity
Treatment Outcome
Tumors of the respiratory system and mediastinum
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Summary:In a recently published randomised trial of chemotherapy versus palliative care in advanced non-small cell lung cancer (the MIC2 trial), chemotherapy was shown to prolong survival without compromising quality of life. The study presented here examines patterns of care and their associated costs within a representative subgroup of patients from the MIC2 trial. The study consisted of 116 patients from the South Birmingham Health Authority area. The total health service cost for each patient from entry to trial to death or last follow-up was calculated by combining the resources used with their associated unit costs. The mean cost for patients with complete data on the chemotherapy arm was £6999 (standard deviation (S.D.) £4194) compared to £4076 (S.D. £3078) for those with complete data on the palliative care arm. Non-parametric bootstrapping gave a difference between treatment arms in mean cost of £2924 (95% CI £1234–£4323). With a difference in mean survival of 2.4 months, this translates to an incremental cost-effectiveness ratio of £14 620 per life year gained. Chemotherapy was found to be more costly than standard palliative care, mainly due to the increased number of hospital in-patient days.
ISSN:0169-5002
1872-8332
DOI:10.1016/S0169-5002(02)00042-9