Cost Utility Analysis of Methotrexate Versus Actinomycin-D in Low Risk Gestational Trophoblastic Neoplasia [2J]. Issue 1 (May 2017)

• Record Type: Journal Article
• Authors: Geisler, John; Manahan, Kelly
• Is Part Of: Obstetrics and gynecology. Volume 129:Issue 1(2017)
• Publication Date: 2017-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000514977.70574.f9
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: To determine the most cost effective first line regimen for women with low risk gestational trophoblastic neoplasia (GTN) (WHO risk score 0-4 and no choriocarcinoma). METHODS: Markov decision model (1000 patients) was used to analyze published data GOG 174. Arm 1 was weekly methotrexate at 30 mg/m 2 weekly while arm 2 was actinomycin-D 1.25 mg/m 2 biweekly. Costs were based on average sale price (ASP) +6%. Utility values were determined by rating scale. RESULTS: The mean cost of therapy for methotrexate arm was $11, 970 (95%CI $11, 149-$12, 791). The mean cost of the actinomycin-D arm was $26, 865 ($26, 780-$26, 950). Weekly methotrexate dominated actinomycin-D as first line therapy. CONCLUSION: First line therapy of low risk GTN should be weekly methotrexate.