A Cost-Effectiveness Analysis of Docetaxel in the Second-Line Treatment of Non-Small Cell Lung Cancer

Background: Whilst lung cancer is the most common form of cancer in England and Wales (annual incidence rate of 50 per 100 Objective: To develop a model to assess the economics of second-line treatment of non-small cell lung cancer (NSCLC) from the perspective of the UK NHS, based on the resources and outcomes from the pivotal clinical study comparing docetaxel 75 mg/m2 with best supportive care (BSC). Methods: The area under the survival curve for each treatment was analysed and the difference in mean survival between the docetaxel group and the BSC group was calculated as 3.82 months. Measurable incremental costs for the docetaxel group were largely driven by drug acquisition and administration. These cost drivers, as well as toxicity treatment costs and cost offsets, were varied in the sensitivity analysis. Although the overall timeframe for the model was 2 years, discounting was not applied as the resources and benefits of docetaxel use in this setting are realised relatively immediately. Results: The base case cost-effectiveness analysis (mean values) reported a cost per life-year gained of Lstg 13 Conclusion: This model suggests, with its underlying assumptions and data, docetaxel 75 mg/m2 in 3-weekly cycles is a cost-effective second-line treatment, from the perspective of the NHS, for pretreated NSCLC in terms of survival gains made for a reasonable increase in costs.