| Description |
Epidemic Kaposis Sarcoma (AIDS- KS) is a rare cancer that occurs frequently among patients infected with Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS). AIDS-KS is one of the most common AIDS-defining malignancies. To address the cosmetic issue and comorbidities associated with KS, the Food and Drug Administration (FDA) approved liposomal doxorubicin, liposomal daunorubicin and paclitaxel. The aim of this study is to compare liposomal doxorubicin (first-line treatment of AIDS KS) to paclitaxel (second-line) through a cost e↵ectiveness analysis and test the hypothesis that the di↵erence in acquisition costs will translate in a cost saving benefit and/or cost-e↵ectiveness. Relevant articles were identified through systematic review of the literature from the National Center for Biotechnology Pub Med database, ISPOR Digest and clinicaltrials.gov using the following medical subject heading (MESH) terms: Kaposis sarcoma, pegylated liposomal doxorubicin, paclitaxel, AIDS-Related Opportunistic Infections, quality of life, costs, and cost analysis. Based on the results, at present, there is no economic study evaluating the cost-e↵ectiveness of liposomal anthracyclines versus paclitaxel. Available cost-studies also showed that liposomal doxorubicin is more cost e↵ective than liposomal daunorubicin; thus liposomal daunorubicin has been removed from the analysis. Cost analyses were done comparing a full treatment of the two drugs. Cost minimization analysis showed that the treatment with liposomal doxorubicin costs $16, 716 whereas paclitaxel costs $13, 333. After accounting for response rate, the results showed that liposomal doxorubicin costs $36, 339 versus $23, 390 for paclitaxel. Paclitaxel is the dominant intervention due to its lower acquisition cost and higher response rate vs. liposomal doxorubicin. In conclusion, there is a large di↵erence in acquisition cost of liposomal doxorubicin and paclitaxel (paclitaxel being less expensive than liposomal doxorubicin). After accounting for all the factors that contribute to cost and response rate, paclitaxel is less costly and cost-e↵ective when compared to liposomal doxorubicin. |
