Cost utility of docetaxel as induction chemotherapy followed by chemoradiation in locally advanced squamous cell carcinoma of the head and neck.

BACKGROUND Trial TAX 324 showed that induction chemotherapy with docetaxel plus cisplatin and 5-fluorouracil (TPF) compared with cisplatin and 5-fluorouracil (PF) followed by chemoradiation increases survival and time to progression in squamous cell carcinoma of head and neck (SCCHN). METHODS A Markov model was developed to estimate the cost-effectiveness of induction chemotherapy with docetaxel in the United Kingdom from the payer perspective. Health states were based on the WHO criteria for objective response to cancer treatments. Efficacy and safety data were obtained from the trial. Resource utilization, costs, and utility data were primarily derived from the literature. RESULTS A patient on TPF gained 4.1 quality adjusted life years (QALYs) versus 2.0 QALYs for PF patient. Corresponding lifetime costs were pound 32,440 and pound 28,718. The cost per QALY gained for TPF versus PF was pound 1782. CONCLUSIONS TPF is cost-effective as induction chemotherapy in locally advanced SCCHN compared with PF. Local treatment patterns may impact findings for other countries.