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Cost-effectiveness of bevacizumab-based therapy versus cisplatin plus pemetrexed for the first-line treatment of advanced non-squamous NSCLC in Korea and Taiwan


  • Declaration of conflict of interest.

  • Ahn M-J is part of the bevacizumab pharmacoeconomic study in NSCLC advisory board. T-C. Hsia has previously received a research grant from F. Hoffmann-La Roche, E Wright and S Walzer are employed by F. Hoffmann-La Roche AG and S Walzer holds shares in F. Hoffmann-La Roche. E-J Bae and M Kang are employed by Roche Korea Co. Ltd., Seoul, Republic of Korea. J-H Kim has previously received a research grant from Roche, Eli Lilly, Astra Zeneca and GSK. J Lister is a health economics consultant employed by Analytica International Inc. and have received consulting fees from F. Hoffman-La Roche AG. The authors do not report any conflict of interest with regard to the contents of this study other than those stated.

Professor Myung-Ju Ahn MD, Section of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea. Email:


Aims:  The aim of this analysis is to investigate the mean incremental costs and life expectancy associated with two first-line treatments for advanced non-squamous non-small cell lung cancer (NSCLC) in Korea and Taiwan; bevacizumab plus cisplatin and gemcitabine (BevCG) and cisplatin plus pemetrexed (CP).

Methods:  A health economic (area under curve) model with three health states was developed to assess health outcomes (life-years gained [LYG]), direct costs, and incremental cost-effectiveness ratio (ICER). Progression-free survival (PFS) and overall survival (OS) were derived from randomized clinical trials and used in an indirect comparison in order to estimate their cost effectiveness. A life-time horizon was used. Costs and outcomes were discounted yearly by 5% in Korea and by 3% in Taiwan.

Results:  The incremental LYG for the BevCG patients compared with patients treated with CP were 1.10 (13.2 months) in Korea and 1.19 (14.3 months) in Taiwan. The incremental costs were inline image37 439 968 ($33 322) in Korea and NT$1 910 615 ($64 541) in Taiwan. The incremental cost-effectiveness ratio was inline image34 064 835 ($30 318) in Korea and NT$1 607 960 ($54 317) in Taiwan. The inputs tested in one-way sensitivity analyses had very little impact on the overall cost effectiveness.

Conclusion:  This analysis shows that BevCG is more costly but is also associated with additional life-years in Korea and Taiwan. The ICER per LYG suggests that BevCG is a cost-effective therapy when compared to CP for patients with advanced NSCLC in Korea and Taiwan.