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Cost-effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum-sensitive, recurrent ovarian cancer.

Publication ,  Journal Article
Havrilesky, LJ; Pokrzywinski, R; Revicki, D; Higgins, RV; Nycum, LR; Kohler, MF; Berchuck, A; Myers, ER; Secord, AA
Published in: Cancer
January 15, 2012

BACKGROUND: In a randomized controlled trial (RCT) of patients with recurrent, platinum-sensitive ovarian cancer, the combination weekly docetaxel and carboplatin was associated a with progression-free survival (PFS) of 13.7 months compared with 8.4 months for sequential, single-agent docetaxel followed by carboplatin. The objective of the current study was to construct a cost-utility model to compare these 2 regimens with the incorporation of prospectively collected quality-of-life (QoL) data. METHODS: An RCT of concurrent docetaxel and carboplatin (cDC) versus docetaxel followed by carboplatin (sequential docetaxel and carboplatin [sDC]) was the basis for a Markov decision model, and the primary effectiveness outcome was PFS. Costs were estimated using US dollars based on Medicare reimbursements for chemotherapy regimens, bone marrow support, and management of adverse events. QoL data obtained using the Functional Assessment of Cancer Therapy-General questionnaire were converted to utilities. Costs and incremental cost-effectiveness ratios (ICERs) were reported in US dollars per quality-adjusted life year (QALY). Extensive 1-way sensitivity analyses and a Monte Carlo probabilistic sensitivity analysis were performed. RESULTS: The least expensive strategy was sDC, which cost an average of $20,381, compared with cDC, which cost an average of $25,122. cDC had an ICER of $25,239 per QALY compared with sDC. cDC remained cost-effective, with an ICER <$50,000 per QALY, over a range of costs and estimates. In Monte Carlo sensitivity analysis using a $50,000 per QALY willingness-to-pay threshold, cDC was either dominant or cost-effective with an ICER <$50,000 per QALY in 83% of simulations. CONCLUSIONS: Combined weekly cDC appeared to be cost-effective compared with sDC as treatment strategy for patients with platinum-sensitive ovarian cancer, even when accounting for slightly lower QoL during treatment.

Duke Scholars

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

January 15, 2012

Volume

118

Issue

2

Start / End Page

386 / 391

Location

United States

Related Subject Headings

  • Taxoids
  • Recurrence
  • Quality of Life
  • Platinum
  • Paclitaxel
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Humans
  • Female
  • Docetaxel
 

Citation

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ICMJE
MLA
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Havrilesky, L. J., Pokrzywinski, R., Revicki, D., Higgins, R. V., Nycum, L. R., Kohler, M. F., … Secord, A. A. (2012). Cost-effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum-sensitive, recurrent ovarian cancer. Cancer, 118(2), 386–391. https://doi.org/10.1002/cncr.26199
Havrilesky, Laura J., Robin Pokrzywinski, Dennis Revicki, Robert V. Higgins, Lawrence R. Nycum, Matthew F. Kohler, Andrew Berchuck, Evan R. Myers, and Angeles Alvarez Secord. “Cost-effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum-sensitive, recurrent ovarian cancer.Cancer 118, no. 2 (January 15, 2012): 386–91. https://doi.org/10.1002/cncr.26199.
Havrilesky LJ, Pokrzywinski R, Revicki D, Higgins RV, Nycum LR, Kohler MF, et al. Cost-effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum-sensitive, recurrent ovarian cancer. Cancer. 2012 Jan 15;118(2):386–91.
Havrilesky, Laura J., et al. “Cost-effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum-sensitive, recurrent ovarian cancer.Cancer, vol. 118, no. 2, Jan. 2012, pp. 386–91. Pubmed, doi:10.1002/cncr.26199.
Havrilesky LJ, Pokrzywinski R, Revicki D, Higgins RV, Nycum LR, Kohler MF, Berchuck A, Myers ER, Secord AA. Cost-effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum-sensitive, recurrent ovarian cancer. Cancer. 2012 Jan 15;118(2):386–391.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

January 15, 2012

Volume

118

Issue

2

Start / End Page

386 / 391

Location

United States

Related Subject Headings

  • Taxoids
  • Recurrence
  • Quality of Life
  • Platinum
  • Paclitaxel
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Humans
  • Female
  • Docetaxel