Pharmacoeconomics of liposomal anthracycline therapy

Pharmacoeconomic analyses are being used with greater frequency in clinical oncology trials. These analyses provide guidelines for prioritizing competing interventions and allocating health care resources, particularly when deciding whether to use a drug with a higher acquisition cost. For liposomal anthracyclines, the competing treatments are other liposomal anthracyclines and nonliposomal chemotherapy agents with similar activity. Pharmacoeconomic analyses of data from clinical trials in patients with Kaposi's sarcoma determined that the overall cost to achieve objective response was substantially lower with pegylated liposomal doxorubicin (Doxil/Caelyx [PLD]) than with liposomal daunorubicin (DaunoXome [DNX]). Additional economic analyses in patients with ovarian cancer showed that PLD has lower overall treatment costs than topotecan because it is administered less frequently and requires fewer interventions for toxicity. The decision to allocate health care resources to liposomal anthracycline treatment must therefore include consideration of cost-effectiveness and potential cost savings owing to improved tolerability.