***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The study consisted of a cost-minimisation analysis since the findings from a multicentre r and omised phase III trial showed that pegylated liposomal doxorubicin hydrochloride was at least as efficacious as topotecan . An economic model from the Spanish hospitals perspective was constructed to compare the costs derived from the treatment using both drugs in patients with recurrent epithelial ovarian cancer who failed a first-line platinum-containing regimen . The cost evaluation included direct medical costs : drug , drug administration and costs of managing adverse events . Estimation of re sources used in managing adverse events was made retrospectively through an expert panel . Results obtained per patient were : cost of drug and administration , 8647.70 euros for pegylated liposomal doxorubicin hydrochloride and 8519.94 euros for topotecan , while cost of managing adverse events was 967.02 euros in the pegylated liposomal doxorubicin hydrochloride arm and 3304.75 euros for topotecan . The total cost per patient was therefore estimated to be 9614.72 euros for pegylated liposomal doxorubicin hydrochloride and 11 824.69 euros for topotecan , showing that pegylated liposomal doxorubicin hydrochloride produces a cost saving of 2209.97 euros per patient in comparison to topotecan . Sensitivity analyses verified the robustness of the results . These findings suggest that pegylated liposomal doxorubicin hydrochloride is an efficient therapy and can be used as a cost-saving option for treatment of patients with recurrent epithelial ovarian cancer who have failed a first-line platinum-containing regimen In the r and omised clinical trial E1684 , the administration of interferon ( IFN ) alpha-2b result ed in prolonged disease-free and overall survival in high-risk melanoma patients following surgical resection . However , and considering the cost and toxicity of IFN , the convenience of its widespread use should be evaluated . The aim of this study was to analyse the cost-effectiveness ratio of adjuvant therapy with IFN alpha-2b in melanoma patients versus an untreated control group . A Markov model was used to compare two hypothetical cohorts of 1000 patients aged 50 years , according to the clinical outcome of the E1684 study . The cohort of patients treated with IFN alpha-2b has an increased overall survival of 1.90 years during the patient 's lifetime . The incremental discounted cost per life year gained of IFN versus observation is 9015 Euros according to the projection generated by the model . The sensitivity analysis demonstrated that changes in the most relevant study end-points do not modify the study outcome . In conclusion , in high-risk melanoma patients following surgical resection , the cost-effectiveness of IFN alpha-2b ( at a dose of 20 MU/m2/day , 5 days per week for one month , followed by 10 MU/m2 TIW , up to one complete year of therapy ) versus an untreated control group is within the limits established in health economics to determine if adoption of a new treatment is economically justified and is comparable with other interventions in which cost-effectiveness is acceptable to the National Health System Introduction The r and omised controlled trial BCIRG001 has recently demonstrated that docetaxel in combination with doxorubicin and cyclophosphamide ( TAC ) has better efficacy than the st and ard treatment ( FAC , i.e. , 5-fluorouracil , doxorubicin and cyclophosphamide ) in the adjuvant treatment of patients with node-positive breast cancer . The cost-effectiveness of TAC vs. FAC in the Spanish setting is analysed . Patients and methods Clinical outcomes from trial BCIRG001 were combined with Spanish costs and long-term efficacy of FAC and TAC extrapolated up to 5 years by means of a Markov model . Results are shown as cost per life year gained ( C/LYG ) and cost per quality -adjusted life year ( C/QALY ) . Costs and effects were discounted at a rate of 3 % . Results Mean survival was 17.8 and 16.5 years for TAC and FAC , with total costs of € 14,611 and € 11,586 , respectively . The results of the cost-effectiveness analysis showed that TAC achieves a C/LYG and a C/QALY of only € 2345 and € 2631 , respectively . Sensitivity analysis confirmed the robustness of the results . Conclusions Combined therapy based on docetaxel ( TAC ) is not only an effective option , but also presents a favourable cost-effectiveness ratio , clearly below the Spanish efficiency threshold in all the scenarios considered A large r and omized clinical trial in advanced , previously untreated , non-small cell lung cancer ( NSCLC ) patients revealed better response rates and better tolerance for paclitaxel+cisplatin ( TAXCIS ) compared to teniposide+cisplatin ( TENCIS ) . Since economic evidence is receiving increasing attention in health care , we conducted an economic evaluation based on the trial results in The Netherl and s , Belgium , France and Spain . The evaluation was based on ( i ) differences in drug costs , ( ii ) differences in chemotherapy administration and ( iii ) the economic consequences of significantly different clinical outcomes in the trial : anemia , thrombocytopenia , neutropenia , neuropathy and arthralgia/myalgia . Data regarding medical re source utilization were obtained from clinician interviews using a Delphi technique and vali date d by patient charts analysis . Differences in medical management occurred across countries , but TAXCIS was cost-additive in all countries , i.e. the extra cost of chemotherapy was only partially compensated by savings in medical re source use , result ing in a net cost per patient of US$ 2311 . In the trial , TAXCIS therapy produced a 37 % response rate compared to 26 % for TENCIS . The cost per extra responder for TAXCIS is on average US$ 21011 , which is comparable to the cost per responder obtained with TENCIS ( US$ 27266 ) . Thus , the cost-effectiveness of TAXCIS , expressed in cost per responder , is similar to the cost-effectiveness obtained with TENCIS INTRODUCTION Information on the relative cost-effectiveness of treatments for cancer is being increasingly sought as pressure on health care re sources increases . The objective of this study was to assess the cost-effectiveness of gemcitabine/cisplatin ( GC ) versus cisplatin/etoposide ( CE ) in patients with advanced non-small cell lung cancer ( NSCLC ) , using re source utilization data collected in conjunction with the first r and omized clinical trial comparing both combinations . METHODS Efficacy and medical care re source utilization data were collected prospect ively in an open-label , multicenter , r and omized , comparative , phase III trial conducted in Spain which compared gemcitabine/cisplatin and cisplatin/etoposide in 135 chemonaive patients with Stage IIIB or IV NSCLC . There were no differences between both regimens when survival was used as primary end-point , so a cost-minimization analysis was used to compare them . In addition , cost-effectiveness analyses were conducted when percentage of responses and time to progression were used as secondary end-points . RESULTS There were no differences between both regimens when survival was selected as the efficacy end-point . Despite the higher chemotherapy cost of GC when compared to CE , there were no differences in total direct costs ( 584523 pts for GC and 589630 pts for CE ; P = NS ) between both regimens . Potential savings with GC were mainly associated with a decrease in hospitalization rate . There were differences in favor of GC when response rate ( 40.6 % for GC and 21.9 % for CE ; P<0.05 ) and time to disease progression ( 8.7 months for GC and 7.2 months for CE ; P<0 . 05 ) were used as clinical end-points . GC presented a favorable cost-effectiveness profile when compared to CE . CONCLUSIONS This prospect i ve economic evaluation conducted alongside a clinical trial offers valuable preliminary information on the potential efficiency of the combination gemcitabine-cisplatin in NSCLC . Future assessment s based on larger clinical trials focused on survival and naturalistic economic studies conducted in real clinical practice setting s are necessary to confirm these findings 
    Output:
    
The major conclusion is that the absence of regulations concerning the application of the efficiency criterion in decision-making on the subject of price and financing and , most importantly , the fact that these are not included in Spanish hospitals forms make it difficult to analyse the real impact of economic evaluations of cancer treatments on such decisions