Abstract 3359: Multiple objective analysis of first line medicine with non-small cell lung cancer
Authors: Fang Yueh-Fu , Lee Min-Chia 
Published: August 2019

Abstract
Background
The standard first line treatments of lung cancer are chemotherapy and targeted therapy. Taiwan launch National Health Insurance since 1995 and Taiwanese can receive medical treatment in a low price. However, National Health Insurance facing bankruptcy so it is important to find which treatment provide good medical effect and low medical cost. We will use analytic hierarchy process (AHP) to combine medical effect and medical cost.
Patients and Methods
We had analyzed the Database of Lung Cancer from Taiwan National Health Insurance Database (NHIRD). The database included the coding of diagnoses, examinations and treatments from 1996 to 2013 in the patients who were diagnosed with lung cancer in 1996 to 2013. The Analytic Hierarchy Process (AHP) is a theory of measurement through pairwise comparisons. It relies on the judgements of experts to get the weight of the pairwise comparison. And it uses the pairwise comparison to derive priority scales. It scales that measure intangibles in relative terms. The methods of survival analysis are Kaplan-Meier method and Life table method.
Results
The aim of the questionnaire for AHP is to get the weights between each criteria or subcriteria. The weight of medical effect is about 71%, and the weight of medical cost is approximately 29%. According to the result of questionnaire, medical effect is much more important than medical cost. There are four part of medical cost. The weight is about 23% in average medical cost in first line. The weight is about 22% in average medical cost related to lung cancer in first line. The weight is approximately 26% in average medical cost per day after receiving first treatment. The weight is about 29% in average medical cost related to lung cancer per day after receiving first treatment. The average progression survival day is 106.86 days. The overall survival day is 262.68 days. The average time of the emergency is 2.15. The average medical cost in first line is 4655.38 new Taiwan dollars per day. The average medical cost related to lung cancer in first line is 4545.92 new Taiwan dollar per day. The average cost after receiving the first treatment is 3369.75 new Taiwan dollar per day. The average cost related to lung cancer after receiving first treatment is 3262.38 new Taiwan dollar. KPI of chemotherapy with Cisplatin or Carboplatin is higher than thatn of chemotherapy without Cisplatin or Carboplatin. For those who only use chemotherapy medicine, the highest KPI is not fixed on a certain medicine. In addition, Alimta is the most expensive one so that the lowest KPI is usually on Alimta.
Conclusion
This is the first time not only using the survival analysis but also using a new method to evaluate the efficiency of a treatment or drug. The future work is to develop a new method based on this analytic model.
Citation Format: Yueh-Fu Fang, Min-Chia Lee. Multiple objective analysis of first line medicine with non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3359.