Incremental cost-effectiveness of the pre- and post-bevacizumab eras of metastatic colorectal cancer therapy in British Columbia, Canada.

Objectives: Bevacizumab, with 5-Fluorouracil-based therapy, has been shown to prolong survival among patients with metastatic colorectal cancer (mCRC), at a relatively high cost. We evaluated the cost-effectiveness of therapy for mCRC in the eras prior to, and following, the introduction of bevacizumab on a population basis.

Methods: All patients with newly-diagnosed mCRC in 2003/2004 (the pre-bevacizumab era) and 2006 (the post-bevacizumab era) referred to the British Columbia Cancer Agency were included.

Erlotinib or best supportive care for third-line treatment of advanced non-small-cell lung cancer: a real-world cost-effectiveness analysis.

Unlabelled: Erlotinib has been approved as a third-line treatment for advanced non-small-cell lung cancer (NSCLC) in British Columbia (BC). A cost-effectiveness analysis was conducted to compare costs and effectiveness in patients who received third-line erlotinib to those in a historical patient cohort that would have been eligible had erlotinib been available.

Methods: In a population of patients who have been treated with drugs for advanced NSCLC, overall survival (OS), progression-to-death survival (PTD) and probability of survival one year after end of second-line (1YS) were determined using a Kaplan-Meier survival analysis.

The ability of cancer-specific and generic preference-based instruments to discriminate across clinical and self-reported measures of cancer severities.

Objective: To evaluate the validity of cancer-specific and generic preference-based instruments to discriminate across different measures of cancer severities.

Methods: Patients with breast (n = 66), colorectal (n = 57), and lung (n = 61) cancer completed the EORTC QLQ-C30 and the FACT-G, as well as three generic instruments: the EQ-5D, the SF-6D, and the HUI2/3. Disease severity was quantified using cancer stage, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) score, and self-reported health status.

Erlotinib or docetaxel for second-line treatment of non-small cell lung cancer: a real-world cost-effectiveness analysis.

Introduction: Erlotinib was recently approved in British Columbia (BC) as a second-line treatment for advanced NSCLC. A cost-effectiveness analysis was conducted which compares costs and effectiveness in patients who received second-line erlotinib with those in patients who received docetaxel.

Methods: In a population of patients who have been treated with drugs (either erlotinib or docetaxel) for advanced NSCLC, overall survival (OS), progression-free survival (PFS), and probability of survival 1 year after beginning of second-line treatment (1YS) were determined using Kaplan-Meier and Cox proportional hazard analysis, as well as χ test.

Priority setting in healthcare: towards guidelines for the program budgeting and marginal analysis framework.

Economists' approaches to priority setting focus on the principles of opportunity cost, marginal analysis and choice under scarcity. These approaches are based on the premise that it is possible to design a rational priority setting system that will produce legitimate changes in resource allocation. However, beyond issuing guidance at the national level, economic approaches to priority setting have had only a moderate impact in practice.

Cost-effectiveness of the addition of rituximab to CHOP chemotherapy in first-line treatment for diffuse large B-cell lymphoma in a population-based observational cohort in British Columbia, Canada.

Background: Diffuse large B-cell lymphoma (DLBCL) has primarily been treated with cyclophosphamide, doxorubicin, vincristine, and predisone (CHOP) chemotherapy since the 1970s. Recently, the addition of rituximab to CHOP (CHOP-R) has been found to improve survival and trial-based results have suggested that it is a cost-effective alternative to CHOP.

Objectives: The objective in this study was to evaluate the cost-effectiveness of CHOP-R relative to CHOP in first-line treatment of DLBCL in a population-based setting in British Columbia, Canada.