Real-world hospital costs for nonchemotherapy drugs and nondrug care associated with platinum-based doublets in the first-line setting for advanced nonsquamous non-small-cell lung cancer in Chinese patients: a retrospective cohort study

Jianhua Chen; Shengqi Wu; Chenping Hu; Yicheng Yang; Narayan Rajan; Yun Chen; Canjuan Yang; Jianfeng Li; Wendong Chen

doi:10.2147/CEOR.S98548

Real-world hospital costs for nonchemotherapy drugs and nondrug care associated with platinum-based doublets in the first-line setting for advanced nonsquamous non-small-cell lung cancer in Chinese patients: a retrospective cohort study

Clinicoecon Outcomes Res. 2016 Apr 26:8:97-111. doi: 10.2147/CEOR.S98548. eCollection 2016.

Authors

Jianhua Chen¹, Shengqi Wu², Chenping Hu³, Yicheng Yang⁴, Narayan Rajan⁵, Yun Chen⁴, Canjuan Yang⁶, Jianfeng Li⁶, Wendong Chen⁷

Affiliations

¹ Department of Medical Oncology, Central South University, Changsha, Hunan, People's Republic of China.
² Department of Research and Education, Hunan Province Tumor Hospital, Central South University, Changsha, Hunan, People's Republic of China.
³ Department of Respiratory, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
⁴ Lilly Suzhou Pharmaceutical Co., Ltd. Shanghai Branch, Shanghai, People's Republic of China.
⁵ Global Health Outcomes Research, Eli Lilly and Co, Indianapolis, IN, USA.
⁶ Division of Health Outcome Research, Normin Health Changsha Representative Office, Changsha, Hunan, People's Republic of China.
⁷ Normin Health, Toronto, ON, Canada.

Abstract

Objective: The objective of this study was to compare hospital costs per treatment cycle (HCTC) for nonchemotherapy drugs and nondrug care associated with platinum-based doublets in the first-line setting for advanced nonsquamous non-small-cell lung cancer (AdvNS-NSCLC) in Chinese patients.

Methods: Patients receiving platinum-based doublets in the first-line setting for AdvNS-NSCLC from 2010 to 2012 in two Chinese tertiary hospitals were identified to create the retrospective study cohort. Propensity score methods were used to create matched treatment groups for head-to-head comparisons on HCTC between pemetrexed-platinum and other platinum-based doublets. Multiple linear regression analyses were performed to rank studied platinum-based doublets for their associations with the log10 scale of HCTC for nonchemotherapy drugs and nondrug care.

Results: Propensity score methods created matched treatment groups for pemetrexed-platinum versus docetaxel-platinum (61 pairs), paclitaxel-platinum (39 pairs), gemcitabine-platinum (93 pairs), and vinorelbine-platinum (73 pairs), respectively. Even though the log10 scale of HCTC for nonchemotherapy drugs and nondrug care associated with pemetrexed-platinum was ranked lowest in all patients (coefficient -0.174, P=0.015), which included patients experiencing any hematological adverse events (coefficient -0.199, P=0.013), neutropenia (coefficient -0.426, P=0.021), or leukopenia (coefficient -0.406, P=0.001), pemetrexed-platinum had the highest total HCTC (median difference from RMB 1,692 to RMB 7,400, P<0.001) among platinum-based doublets because of its higher drug acquisition costs (median difference from RMB 4,636 to RMB 7,332, P<0.001).

Conclusion: Among Chinese patients receiving platinum-based doublets in the first-line setting for AdvNS-NSCLC, the higher acquisition costs for nonplatinum cytotoxic drugs associated with pemetrexed-platinum could be partially offset by its significantly lower hospital costs for nonchemotherapy drugs and nondrug care.

Keywords: Chinese; first line; hospital costs; nonsquamous non-small-cell lung cancer; platinum-based doublet.