Economic Evaluation of Pemetrexed Versus Docetaxel as Second-line Therapy of Patients with Advanced Non-small Cell Lung Cancer

OBJECTIVE To evaluate and compare the cost-effectiveness of pemetrexed and docetaxel as the second-line chemotherapy for advanced non small cell lung cancer(NSCLC), using an economic analysis. METHODS Search the database then select the qualified randomized phase Ⅲ trials about second-line therapy for advanced non small cell lung cancer, which was treated with pemetrexed and docetaxl. Analyse the cost-effectiveness of these two chemotherapy regimens by comparing the disease control rate, objective response rate. RESULTS Seven out of 469 articles were available, including 1 372 cases of patients, 687 for pemetrexed group and 685 for docetaxel group. There was no significant difference in disease control rateRR=0.97, 95%CI(0.87, 1.08), P=0.54 and objective response rateRR=1.22, 95%CI(0.89, 1.68), P=0.21. Compared with pemetrexed group, docetaxel group had significantly higher rates of Ⅲ and Ⅳ degree of neutrophil decrease, alopecia and neurovirulence. And the cost-effectiveness ratio was lower in the docetaxel group than in the pemetrexed group with the minimum cost of 13 397.68 yuan. CONCLUSION There is no significant difference between pemetrexed and decetaxel in the treatment of advanced NSCLC as a second-line chemotherapy. Pemetrexed chemotherapy has a lower adverse rate, and higher treatment cost. Taking the cost into consideration, the therapy of docetaxel is more optimal then pemetrexed for advanced NSCLC.