Economic impact of paclitaxel shortage in patients with newly diagnosed ovarian cancer

Laura J. Havrilesky*, Craig F. Garfield, Jason C. Barnett, David E. Cohn

*Corresponding author for this work

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Objective: To determine the potential economic impact of a paclitaxel drug shortage in patients with newly diagnosed, untreated ovarian cancer. Methods: A modified Markov state transition model with a 6 cycle time horizon compared two scenarios: (1) Standard treatment (STD): paclitaxel 175 mg/m2/carboplatin AUC 5 × 6 cycles; (2) Paclitaxel drug shortage (DS): docetaxel 75 mg/m2/carboplatin AUC 5 × 6 cycles. Adverse events, quality of life, and costs of chemotherapy, neuropathy, febrile neutropenia, and anemia were incorporated. Key assumptions: (1) Costs and consequences were assigned only to grade 2 + neuropathy, febrile neutropenia, and grade 3-4 anemia; (2) Grade 2 + neuropathy prompted a switch from paclitaxel/carboplatin to docetaxel/ carboplatin or from docetaxel/carboplatin to carboplatin alone; (3) Febrile neutropenia resulted in inpatient hospitalization followed by G-CSF prophylaxis. Results: The mean cost of 6 cycles of chemotherapy was $4939 in the STD and $16,107 in the DS scenario, for a cost difference of $11,168 per patient over 6 cycles of treatment. STD was the dominant strategy (less expensive and more effective than the drug shortage scenario). In sensitivity analysis, DS was more costly over a wide range of clinical estimates in each arm. A drug shortage that affects approximately 50% of women initiating chemotherapy is expected to impact 779 women and cost third party payers an additional $8,699,872 monthly. Conclusions: Our model indicates that chemotherapy drug shortages can have a significant negative impact on the average cost of primary treatment for ovarian cancer and have the potential to negatively impact health system costs.

Original languageEnglish (US)
Pages (from-to)631-634
Number of pages4
JournalGynecologic oncology
Volume125
Issue number3
DOIs
StatePublished - Jun 1 2012

Keywords

  • Drug shortage
  • Ovarian cancer
  • Paclitaxel

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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