Cost-effectiveness of real-world administration of chemotherapy and add-on Viscum album L. therapy compared to chemotherapy in the treatment of stage IV NSCLC patients.

BACKGROUND

For stage IV lung cancer patients receiving add-on Viscum album L. (VA) treatment an improved overall survival was detected. Information regarding cost-effectiveness (CE) for comparisons between chemotherapy (CTx) and CTx plus additive VA in stage IV lung cancer treatment is limited. The present study assessed the costs and cost-effectiveness of CTx plus VA (V) compared to CTx alone (C) for stage IV non-small cell lung cancer (NSCLC) patients treatment in a hospital in Germany.

METHODS

In the observational real-world data study, data from the Network Oncology clinical registry were utilized. Enrolled stage IV lung cancer patients received the respective therapy (C or V) in a certified German Cancer Center. Cost and cost-effectiveness analyses from the hospital's perspective were investigated on the basis of overall survival (OS) and routine financial controlling data. In addition, the incremental cost-effectiveness ratio (ICER) was calculated. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis.

RESULTS

118 patients (C: n = 86, V: n = 32) were included in the analysis, mean age 63.8 years, the proportion of male patients was 55.1%. Adjusted hospital's total mean costs for patients from the C and V group were €16,289, 95%CI: 13,834€-18,744€ (over an adjusted mean OS time of 13.4 months) and €17,992, 95%CI: 13,658-22,326 (over an adjusted mean OS time of 19.1 months), respectively. The costs per additional OS year gained (ICER) with the V-therapy compared to C therapy were €3,586.

CONCLUSION

The findings of the present study suggest that the combined use of chemotherapy and VA was clinically effective and comparably cost-effective to chemotherapy alone in our analysed patient sample from the hospital's perspective. Further randomized and prospective cost-effectiveness studies are necessary to complement our findings.

Déclaration de conflit d'intérêts

CG reports grants from Iscador AG, outside the submitted work. BM received fees for lectures or advisory boards from AstraZeneca GmbH, Boehringer Ingelheim AG & Co. KG, Helixor Heilmittel GmbH, Kyowa-Kirin GmbH, Leo GmbH, Lilly Deutschland GmbH, Roche Deutschland Holding GmbH, Teva GmbH outside the submitted work. BM received grants for travelling from AstraZeneca GmbH, BMS GmbH & Co. KG, Boehringer Ingelheim AG & Co. KG, Celgene GmbH, Helixor Heilmittel GmbH, Iscador AG, Jannsen, Kyowa-Kirin GmbH, Leo, Lilly, Novartis, MSD Sharp & Dohme GmbH, Pfizer Deutschland GmbH, Roche Deutschland Holding GmbH, Teva GmbH, outside the submitted work. FS reports grants from ABNOBA GmbH, AstraZeneca GmbH, Helixor Heilmittel GmbH and Iscador AG outside the submitted work. Grants from AstraZeneca GmbH and Helixor Heilmittel GmbH include travel costs and honoraria for speaking. HM is a member of the board of directors of Weleda AG and a member of the Network Arbeitsgemeinschaft der Wissenschaftlichen Fachgesellschaften (AWMF e.V.) guideline committee for integrative oncology (Guideline for Complementary Medicine in the Treatment of Oncological Patients). HM has an endowed professorship at the Charité Universitätsmedizin Berlin, which is financed by the Software AG Foundation, outside the submitted work. The Network Oncology was funded by unrestricted research grants from Iscador AG Arlesheim, Switzerland; ABNOBA GmbH Pforzheim, Germany; and Helixor GmbH Rosenfeld, Germany. The funders had no role in study design, data collection, analysis, decision to publish, or preparation of the manuscript. By contract, researchers were independent from the funder. There are no other relevant declarations relating to employment and consultancy to declare. There are no patents, products in development or marketed products to declare. There are no other relationships/conditions/circumstances that present a potential conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials. No payment was received for any other aspects of the submitted work. The other authors have declared that no competing interests exist.