UNASSIGNED: e16630 Background: @entity2 confers a substantial burden on @entity1 and healthcare systems. Among @entity1 with resectable @entity1149 ( @entity1149 ), adjuvant chemotherapy (AC) has improved survival, but uptake has been incomplete. To determine the impact of increased use of AC, microsimulations were undertaken using the @entity5 Risk Management (CRM) model developed by Statistics Canada and the Canadian Partnership Against @entity5 . METHODS: The CRM model uses inputs from Canadian demographics, risk factors, direct healthcare costs, and clinical practice data to assess incremental life expectancy (LE), @entity2166 ( @entity2166 ), and cost from the perspective of the Canadian healthcare system. Sensitivity analysis examined rates of use of AC over a range of 0-100% in 10% increments. The baseline regimen tested was 4 cycles of @entity900 and @entity1206 (PV) assuming a 50% uptake with a hazard ratio (HR) of 0.68 for overall mortality. Sensitivity analysis with HR=0.74 was performed. Alternate regimens included @entity900 and @entity2879 (given for 3 or 4 cycles (PE3, PE4) and assessing a HR range of 0.95 to 0.68), @entity136 with @entity900 (PG) or @entity3003 (CG) (HR=0.68) and baseline PV plus bevacizumab q3 weeks to 1 year (EPB). RESULTS: In the PV baseline scenario, LE was 76.2 years, @entity2166 was 66.2 years and the lifetime cost per @entity1 was  32,290. Adjuvant chemotherapy remained cost-effective under the sensitivity analysis (HR=0.74). Each 10% increase in the use of AC resulted in an average increase of 3.7 months in LE and 2.7 months in @entity2166 , and a lifetime cost savings of up to  360 per @entity1 . Compared with baseline PV, the PE regimen was not cost-effective, with the exception of PE3 assuming HR = 0.68. PG and CG were less cost-effective than PV, at an additional lifetime cost of  589 and  1023 per @entity1 , respectively. The EPB scenario would be cost-effective at  100,000 per QALY compared to baseline PV if the survival HR=0.55. CONCLUSIONS: The CRM model suggests greater use of PV AC in @entity1149 would improve LE and net healthcare costs, with other drug pairs being less cost-effective. The HR required for bevacizumab to be cost-effective will be difficult to achieve in current trials.

Impact of increased use of adjuvant chemotherapy in XXXX : A population and economic assessment.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer'] @entity3003 :: ('MESH:D016190', 'Chemical') :: ['carboplatin'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC', 'non-small cell lung cancer'] @entity2 :: ('MESH:D008175', 'Disease') :: ['Lung cancer'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity1206 :: ('MESH:C030852', 'Chemical') :: ['vinorelbine'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity2166 :: ('MESH:D000275', 'Disease') :: ['health-adjusted life expectancy', 'HALE'] @entity136 :: ('MESH:C056507', 'Chemical') :: ['gemcitabine']
@entity1149 :: (MESH:D002289,Disease) :: ['non-small cell lung cancer']
