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E. Perez Fernandez
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P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.01-048 - Cost-Effectiveness of Pemetrexed for Advanced Non-Squamous Non-Small Cell Lung Cancer (nsNSCLC) in Patients Treated in a Spanish Institution (ID 2777)
09:30 - 09:30 | Author(s): E. Perez Fernandez
- Abstract
Background:
Pemetrexed (Pem) is a widespread used drug as standard treatment option in patients diagnosed of nsNSCLC in different settings: first line combined with platinum, maintenance or second line treatment. The aim of this study is to assess the cost-effectiveness of Pem-based chemotherapy in routine clinical practice from the perspective of the Spanish National Health System.
Methods:
We evaluated retrospectively clinical outcomes, in terms of overall survival (OS) and progression free survival (PFS), in patients diagnosed of advanced nsNSCLC from 2005 to 2014 who were treated with Pem-based chemotherapy, and we performed a cost-effectiveness analysis. We assessed the cost-effectivenss of the use of Pem-based treatment in routine clinical practice calculating the cost per life years gained (LYG) from the first time the patient received Pem, based on the price established in Spain and the number of cycles received. We calculated OS from the start date of Pem to the death or last contact with the patient, and PFS from the start date of Pem to first tumor progression after Pem.
Results:
114 patients treated with Pem-based chemotherapy were reviewed, 78.9% men and 21.1% women. Mean age at diagnosis was 64 (range 36-81). 80.7% were smokers or former smokers. 90.4% were stage IV and 9.6% IIIB. The predominant histology was adenocarcinoma (69.3%), followed by large cell carcinoma (22.8%), NSCLC-NOS (7%) and pleomorphic carcinoma (0.9%). 59.6% of patients received Pem in first-line and/or maintenance (1L - Maint.), and 40.3% in second or successive lines. The majority of them had a good functional status; ECOG 0 25,4% and 1 59,6%. Median number of received Pem cycles was 5 (range 1-39). Median number of treatment lines was 3 (range 1-8). Clinical outcomes: 68.6% obtained clinical benefit (46.1% stable disease, 21.5% partial response, and 1% complete response). Median progression free survival (PFS) was 5.16 months in 1L- Maint., and 4.55 months in second or successive lines (p = 0,278). Median OS was significantly better in 1L – Maint. setting than in second or successive lines (17.8 vs 9.8 months (p = 0,033)). The mean cost of Pem-based chemotherapy per LYG was 18988 euros in 1L-Maint. setting and 17095 euros in second or successive lines.
Conclusion:
From the perspective of the Spanish National Health System, Pem-based chemotherapy was cost-effective in both first line and/or maintenance setting, and second or successive treatment lines in our patients. The cost per life year gained (LYG) from treatment with Pem was below the standard threshold of 30000 euros.
