Docetaxel is an effective treatment in combination with cisplatin for advanced ovarian cancer. Taxane compounds like docetaxel, however, are notably more expensive than other available treatments. Researchers at the Russian Academy of Medical Sciences compared the total costs associated with use of docetaxel/cisplatin with those of the less expensive regimen of cyclophosphamide/cisplatin as first-line therapy to assess cost effectiveness.

Costs of full treatment for 26 advanced ovarian cancer patients started on cyclophosphamide/cisplatin from 1996 to 1998 were compared with those for 26 patients started on docetaxel/cisplatin from 1998 to present.

As expected, direct costs of first-line docetaxel/cisplatin (7257 thousand rubles) were higher than for first-line cyclophosphamide/cisplatin (1152 thousand rubles).

However, patients receiving first-line cyclophosphamide/cisplatin required more cycles of second-line and subsequent treatments. These additional treatments often included docetaxel or paclitaxel. As a result, costs for full treatment were similar between the two groups: 8409 thousand rubles for first-line docetaxel/cisplatin compared with 7742 thousand rubles for the cyclophosphamide/cisplatin regimen.

First-line docetaxel/cisplatin therapy was also more effective, with 76% of patients achieving a clinical response compared with 60% of patients receiving first-line cyclophosphamide/cisplatin. Thus, cost effectiveness was similar for the two regimens: 111 thousand ruble/% cost effectiveness for docetaxel/cisplatin and 120 thousand ruble/% cost effectiveness for cyclophosphamide/cisplatin.

The researchers emphasized the need to consider the cost of subsequent treatment in addition to first-line costs when assessing cost effectiveness of expensive but effective drugs such as docetaxel.