Cost Evaluation of the «platinum based» therapy as first line treatment of the advanced non-small-cell lung cancer, by the Health Agency of the Region of Marche.

Non-small cell lung cancer (NSCLC) is the most frequent type of lung cancer (80% among all types of lung cancer) and it represents a serious sanitary problem for the high mortality rates and the costs. Currently, platinum-based regimens that use new chemotherapeutic agents such as gemcitabine, vinorelbine, paclitaxel and docetaxel (GEM, VNR, PTX, DTX), are considered standard treatments for stage IIIb-IV NSCLC. Randomized clinical trials and comparative studies have not statistically shown significant differences among the various chemotherapeutic regimens in term of survival or objective response for the treatment of patients with advanced NSCLC. In the absence of a specific protocol that shows a significant difference of effectiveness or toxicity in comparison with the others, a cost minimisation analysis has been conducted comparing six platinum-based treatments, by the Health Agency of the Region of Marche (ASUR). The mean total treatment costs (6 cycles) per 100 patients were € 452.096, € 467.550, € 703.251, € 814.366, € 825.887 and € 841.978 for the CDDP+PTX, CBDCA+PTX, CDDP+GEM, CDDP+VNR, CBDCA+DTX, e CDDP+DTX, respectively. From the point of view of ASUR the schemes platinum-based employing paclitaxel are the most advantageous among the other options and allow a remarkable saving in comparison with existing protocols