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Trabectedin plus PLD versus PLD monotherapy in patients with platinum-sensitive relapsed ovarian cancer: a cost-effectiveness analysis in Spain

Objective To evaluate the cost effectiveness of trabectedin plus pegylated liposomal doxorubicin (PLD) versus PLD monotherapy in patients with platinum-sensitive relapsed ovarian cancer from the perspective of the Spanish National Health Service. Methods A decision analytical model was developed to estimate the total treatment-related costs and clinical benefits of trabectedin plus PLD and PLD alone. Patient data and utilities were obtained from the OVA-301 study. Adverse event management costs were obtained from the literature. Other unitary costs (euros, 2011) were obtained from a Spanish healthcare cost database and the Catalogue of Medicines. Costs and benefits (quality adjusted life years (QALYs)) were discounted at 3%. Sensitivity analyses were performed. Results Trabectedin plus PLD yielded greater health benefits (2.35 QALYs) than PLD alone (1.86 QALYs). The global costs (treatment, adverse events management, and medical management) per patient were €45 573 and €23 072 for trabectedin plus PLD and PLD alone, respectively. The incremental cost-effectiveness ratio of trabectedin plus PLD versus PLD was €45 592/QALY gained. Conclusions Compared with PLD alone, the trabectedin plus PLD combination is an effective therapy that slightly exceeds the common threshold (€45 000/QALY gained).