Universitas Indonesia Conferences, Asian Federation for Pharmaceutical Sciences (AFPS) 2019

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Pharmacoeconomic Study of Paclitaxel-Carboplatin and Pemetrexed-Carboplatin Chemotherapy Regimen in Patients With Pulmonary Adenocarcinoma at Persahabatan Hospital, Jakarta
Rianyta Sandjaja, Melva Louisa, Elisna Syahruddin, vivian soetikno

Last modified: 2019-07-12


Background:At present, platinum-based chemotherapy regimens with two types of drugs such as paclitaxel-carboplatin and pemetrexed-carboplatin are first-line therapy for pulmonary adenocarcinoma patients with negative epidermal growth factor receptor (EGFR) mutations. At Persahabatan Hospital, the two regimens are widely used and guaranteed by the Health Social Security Organizing Agency. With the price of pemetrexed which is more expensive and the effectiveness is unknown, it is necessary to do a pharmacoeconomic studies.  Objective:This study aimed to determine the toxicity, efficacy, and cost profile of paclitaxel-carboplatin comparing pemetrexed-carboplatin. Materials and Methods:This study is a cross-sectional study, using medical record data. Patients with pulmonary adenocarcinoma negative EGFR mutations first diagnosed and treated with paclitaxel-carboplatin or pemetrexed-carboplatin were included. Pharmacoeconomic analysis is performed on the basis of clinical outcomes consisting of effectiveness and direct medical costs. Effectiveness was assessed based on overall response rate (ORR). Results: Medical records from 21 patients with paclitaxel-carboplatin and 21 patients with pemetrexed-carboplatin were successfully evaluated. The effectiveness of the two chemotherapy regimens was not significantly different, which was seen from the ORR (P = 0.739). The most common hematologic toxicity was anemia grade 1 in pemetrexed-carboplatin regimen 61.9%, neutropenia grade 1 in paclitaxel-carboplatin regimen 28,6%. Nonhematological toxicity was same, which is nausea vomiting 71.4% and hair loss 61.9%. From the calculation of cost minimisation analysis the results showed that the average cost per patient with pulmonary adenocarcinoma negative EGFR mutation with paclitaxel-carboplatin regimen was cheaper Rp. 11,827,039.15 or 54.09% compared to pemetrexed-carboplatin. Conclusion:there was no difference in effectiveness between the two regimens. The average cost per patient with paclitaxel-carboplatin regimen was cheaper compared to pemetrexed-carboplatin. A prospective study is required with a larger number of study subjects and involves many hospitals.