Comparative Cost-Effectiveness of Paclitaxel-Cisplatin (TP) vs Cyclophosphamide-Cisplatin (CP) in Women with Advanced Epithelial Ovarian Cancer: Results from a Randomized Trial

Ivor Benjamin, MD
OncoLink Assistant Editor
Last Modified: May 21, 2000

Presenter: Hugh Walker
Affiliation: Queens Univ. and Tom Baker Cancer Ctr, Canada

This sub-analysis of 160 patients in the intergroup trial (EORTC-GCCG, NOCOVA, NCIC-CTG, SGCSG) compares the cost effectiveness of paclitaxel (Taxol) - cisplatin (TP) vs. cyclophosfamide-cisplatin in the treatment of epithelial ovarian cancer.

Materials and Methods:

  • 160 of 680 patients originally randomized to receive TP vs. CP were analyzed for cost comparison.
  • The study group were the patients randomized by the NCIC-CTG in the original trial.
  • Cost-effectiveness (CE) defined as incremental cost per incremental life-year gained) based on median overall survival in Canadian patients.
  • CE was $13,135 (US Dollars) for TP vs. CP
  • The gross cost per progression-free life year gained on the TP arm was $21,321
Authors' Conclusions
  • CE for the gain in overall survival from TP is well below the commonly cited threshold for cost-effective care of $50,000 per incremental life-year of overall survival.
  • TP has acceptable CE in the treatment of epithelial ovarian cancer
Clinical/Scientific Implications:
  • When compared with other life-extending therapies (e.g. renal dialysis) TP is cost effective
  • Oncologists treating ovarian cancer patients with TP may wish to cite this study if their patients are denied reimbursement by health insurance providers.