Management and treatment costs of non-squamous metastatic or locally advanced non-small cell lung cancer

Abstract

This article presents the results of clinical trials of oral vinorelbin (NVBo) in patients with non-small cell lung cancer (NSCLC). We described the results of NAVoTRIAL01, randomized phase II trial, in which 153 patients were randomized to either arm A (treated with oral vinorelbineith cisplatin — NVBo + P, 102 pts.) or arm B (pemetrexed with cisplatin — Pem + P, 51 pts.). Disease control rate was 75% and 76,5% in arms A and B, respectively. Median of progression-free survival was 4.2 and 4.3 months and overall survival 10.2 and 10.8 months in arms A and B, respectively. There were no differences regarding toxicity profile between the study arms.

Based on NAVoTRIAL01 cost analysis of oral vinorelbine and pemetrexed in the treatment of NSCLC was made. In cost calculation, perspective of public payer and patient was taken, but it should be noticed, that the costs are paid mainly by public payer. All crucial direct medical costs of therapy were included. According to the calculations, total cost of treatment Pem + P is about 51.400 PLN and NVBo + P is about 19.300 PLN. It seems that the major component of the therapy costs is the drugs cost (about 80% of total cost).

It may be presumed that the NVBo + P treatment results in much lower cost for public payer and patient than Pem + P. Apart from that, considering clinical efficacy, it appears that the use of NVBo + P in clinical practice is justified.