[Inhaled corticosteroids in asthma: a medico-economic analysis of clinical trials].

International audienceBACKGROUND: Asthma is a chronic disease with a heavy economic burden in terms of public health on account of its clinical impact and consequences on quality of life and costs. Its management is based on pharmacological measures with inhaled corticosteroids playing a large role. The objective of this study was to undertake an analysis of the published literature of medico-economic trials of the use of inhaled corticosteroids. METHODS: A review of the literature from 1990 to 2007 was undertaken with separate analyses of studies of inhaled steroids alone and those looking at combined preparations. RESULTS: The costs of asthma vary greatly depending on the clinical management. Analysis of the published clinical trials showed that the addition of inhaled steroids increased the total cost. When efficacy is taken into account the economic results are acceptable for developed societies. The use of inhaled steroids as maintenance therapy, or maintenance and symptomatic therapy, was always cost effective. CONCLUSION: These results are based on data from clinical trials. They need to be confirmed by large scale observational studies using validated criteria of effectiveness

[Stage IV NSCLC. Economic analysis in lung cancers].

International audienceOBJECTIVE: To explain the help of economic analyses in the understanding of lung cancer (LC) management with a description of the quality of selected papers. METHODS: In the first part, quality criteria of economic analyses are depicted with the key words for the literature selection. RESULTS: The global costs of LC through literature review are depicted; then, in a second part, the costs of each stage of the disease. Finally, costs of chemotherapeutic drugs and target molecules are also discussed. CONCLUSION: Economic analyses are unavoidable to assess the burden of the disease but also the cost of each management strategy for LC

[Economic impact of second- and third-line erlotinib treatment of non small-cell lung cancer].

International audienceOBJECTIVE: This study examined care consumption and management costs among patients who received second- or third-line oral erlotinib therapy for non small-cell lung cancer (NSCLC). METHODS: The study involved two observational cohorts of NSCLC second- or third-line treated patients. In the first, patients received IV chemotherapy alone (233 patients), while patients in the second cohort, received oral erlotinib (166 patients). Only direct costs were taken into account. The analysis adopted the payer's perspective. RESULTS: The treatments lasted a similar length in the second- line setting (respectively 94,5+/-67,5 and 105+/-79,4 days for the IV and erlotinib cohorts) but was significantly longer in the erlotinib cohort during third-line therapy (76.6+/-96.5 versus and 114.4+/-74.5 days, p<0.008). In the erlotinib cohort, there were more women (p=0.023), a higher rate of adenocarcinoma (p=0.0043), a similar rate of conventional hospitalization, but less daycare clinics (p<0.001). The erlotinib cohort received significantly less antiemetic treatment (p<0.0001), erythropoietin stimulating agents (p<0.005) and G-CSF (p<0.001). Monthly management costs per patient in the IV and erlotinib cohorts were respectively 3126 +/-1904 and 2750+/-1450 euros during second-line treatment, and 3026+/-1029 and 2823+/-1490 euros during third-line treatment (no significant difference). These results must be validated by prospective observational studies focusing on quality of life and the time spent in hospital