Pharmacoeconomics of cisplatin-based chemoradiation in cervical cancer: a review

Is the use of cisplatin-based chemoradiation therapy, which has become the new standard of care for locally-advanced cervical cancer, cost-effective? To evaluate this, a pharmacoeconomic analysis of five recent Phase III trials of cisplatin-based chemoradiation for the treatment of locally-advanced cervical cancer was conducted. Using an economic model, we applied cost data to resource-use data derived from the cisplatin-based chemoradiation arms of these randomised trials. We examined the cisplatin-based chemoradiation benefits in terms of increased median survival time. Incremental costs were divided by the difference in survival to determine the cost per patient benefited. Cost per life-year gained were calculated based on both published survival and estimated survival. Costs of cisplatin-based chemoradiation therapy regimens per life-year gained varied from US$2709 - 27,882 based on published survival and US$350 - 2860 based on estimated survival. Variations in regimen cost were largely dependent on in-patient or out-patient administration costs. Costs for cisplatin and 5-flourouracil were US$10,037 per in-patient compared to US$3431 for out-patient treatment. In conclusion, cisplatin-based chemoradiation regimens increased mean survival at an acceptable cost per life-year gained in both the in-patient and out-patient settings.