Methods of Intelligent Analysis for Assessing The Effectiveness of Medicines used in Non-Small Cell Lung Cancer

 

Suyunov Nizom Davurovich¹, Rajabova Nargiza Khalimovna²*

¹Doctor of Sciences in Pharmaceutics, Professor, Head of Department of Pharmaceutical Organization of the Tashkent Pharmaceutical Institute, ORCID: 0000-0002-2712-958X

²Doctor of Philosophy (PhD) Pharmaceutical Sciences, Senior Lecturer of the Department of Pharmaceutical Organization of the Tashkent Pharmaceutical Institute. ORCID:0000-0003-2237-150X

 

ABSTRACT:

Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases, with adenocarcinoma and squamous cell carcinoma being the predominant histological subtypes. The high cost of novel therapies has led to the need for comprehensive pharmacoeconomic evaluations to optimize treatment strategies. This study was determined on the evaluation of the effectiveness of medicines used for in non-small cell lung cancer by intellectual analysis methods. A questionnaire was conducted among medical experts and the research used statistical, modern methods of intellectual data analysis, methods of processing information on medicines consumption, in particular preprocessing, domination intervals and generalized estimations. The results of the expert assessment serve as a basis for improving the supply of medicines to patients with lung cancer, and for the production of new medicines or their generics for manufacturing pharmaceutical enterprises. The results of the expert assessment serve as a basis for improving the supply of medicines to patients with lung cancer, and for the production of new medicines or their generics for manufacturing pharmaceutical enterprises.

 

 

INTRODUCTION:

Non-small cell lung cancer is one of the diseases with the highest morbidity and mortality among oncological diseases¹. In the last 10 years, it has been found that the treatment of the metastatic type of the disease with the help of targeted therapy and immunotherapy has achieved high efficiency, but the treatment of the early stages of the disease remains unchanged².

 

Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer death worldwide³. The American Cancer Society estimated about 235,760 new lung cancer cases and 131,880 lung cancer deaths in 2021⁴. Non-small cell lung cancer is the main subtype of lung cancer, accounting for approximately 80–85% of primary lung cancers⁵. In patients with large non-small cell lung cancer at diagnosis, the disease is progressive or metastatic, and their prognosis remains poor⁶. Lung cancer is the leading cause of cancer death worldwide, it is also the leading cause of cancer death in Japan, with an estimated 78,000 lung cancer deaths occurring in 2017 (20.6% of all cancer deaths). Non-small cell lung cancer accounts for 80% of lung cancer cases. Due to the aging of the Japanese population, the number of elderly patients with non-small cell lung cancer in Japan is increasing⁷. Non-small cell lung cancer is characterized by various medicines-induced genetic abnormalities, including ROS1 and ALK⁸. adjustments that share common clinical features and therapeutic strategies⁹. Effectiveness indicators of medicines used in non-small cell (adenocarcinoma) lung cancer conducting a questionnaire among medical experts, processing and determining it in modern intellectual analysis methods. The purpose of the research is to determine the group of medicines using intellectual methods, in particular, by calculating the generalized estimation of the object.

 

MATERIALS AND METHODS:

About 85% of lung cancers are non-small cell lung cancers (NSCLC), with 30–45% adenocarcinoma and 25–40% squamous cell carcinoma. More than half of newly diagnosed patients present with stages I–IV, and median overall survival ranges from 7.0 to 12.2 months, depending on histology, treatment, and other factors (1). Modern systemic treatment options for NSCLC include conventional chemotherapy, targeted therapies, and immunotherapy (immune checkpoint inhibitors)³. Standard management currently combines surgery, radiation therapy, and systemic treatments, while advances in immuno-oncology provide hope for improved patient outcomes⁴.

 

While novel therapies can increase life expectancy, they also raise drug costs. Given limited healthcare budgets and the growing number of expensive medicines, pharmacoeconomic analyses are essential ⁵. Adenocarcinoma incidence is increasing, and early lesions are detectable as ground-glass nodules on computed tomography. Screening programs have increased detection, emphasizing the need to study natural history, progression factors, and treatment strategies⁸.

 

This questionnaire-based study is the first in Uzbekistan to assess the effectiveness of NSCLC drugs⁹. Statistical and modern intellectual analysis methods were applied, along with drug consumption processing techniques ^10-12. Questionnaires were completed by chemotherapists and thoracic oncologists to evaluate drug effectiveness in non-small cell lung adenocarcinoma. Medicines were classified into four groups based on form, dosage, ease of use, and perceived effectiveness.

 

 

Evaluating generic drugs is challenging, as bioequivalence studies do not reflect large-scale clinical outcomes. Patients often prefer modern, original medications, particularly imported drugs ¹⁸. Expert competence was determined based on experience, academic level, specialty, and other parameters. Initial data processing assigned each medicine to a group based on expert responses. Values ranged from 0–10 and were divided into four categories: 1 (0–5.6), 2 [5.6–7.1), 3 [7.1–8.6), and 4 [8.6–10).

 

The study employed intellectual analysis to calculate a generalized estimation for each medicine. Objects (medicines) were characterized by nominal symptoms (expert answers) with four gradations⁴. A two-class comparison was applied, for example, contrasting chemotherapists’ evaluations with thoracic oncologists’ assessments^13,14. Missing values were addressed using advanced intellectual methods rather than deletion or imputation^15,16.

 

Based on expert experience, academic level, and other parameters, initial redistribution of medicines into groups was performed¹⁷. Generalized class membership scores were calculated and compared to expert assessments¹¹. Four independent experiments were conducted, each time assigning one group as the primary class and others to the comparison class. For each medicine, the group with the highest generalized score across experiments determined its final classification.

 

This method allowed structured, objective evaluation of NSCLC therapies even in the presence of incomplete expert data, facilitating reliable classification of medicines by effectiveness, usability, and dosage

 

RESULTS:

The questionnaire was distributed to the specialists-doctors of the Republican scientific-practical center of oncology and its regional branches, and was evaluated by experts on the effectiveness of medicines. The results were summarized and processed. According to the 10-point evaluation system of medicines, evaluations on 4 scales were divided into groups

 

Table 1: Efficacy rates of cisplatin international non-proprietary name medicines in non-small cell lung adenocarcinoma

No.	International non-proprietary name / Trade names	Medicine form	0–5.5	5.6–7.0	7.1–8.5	8.6–10	Program Evaluation
1	Cisplatin ebeve®, 50mg/100ml	Concentrate for preparation of solution for infusions	0.01	0.64	0.00	1.00	4
2	Cisplatin-naprod, 50mg/50ml	Solution for intravenous infusion	0.13	0.54	0.74	0.38	3
3	Vivacislatin, 10mg/20ml, No. 1	Concentrate for preparation of solution for infusions	0.36	0.90	0.01	0.16	2
4	Vivacislatin, 50mg/50ml, No. 1	The same	0.35	0.95	0.11	0.05	2
5	Cisplatin ebeve®, 0.5mg/ml	// – //	0.12	0.81	0.20	0.14	2
6	Cisplatin ebeve®, 10mg/20ml	// – //	0.12	0.82	0.14	0.18	2
7	Cisplatin ebeve®, 25mg/50ml	// – //	0.10	0.71	0.15	0.26	2
8	Cisplatin-naprod, 10mg/10ml	Solution for intravenous infusion	0.15	0.68	0.35	0.16	2
9	Celplat, 50, 50mg/ml 50ml, No. 1	Solution for infusions	0.97	0.40	0.05	0.25	1
10	Cislkyu spal 10, 10mg/10ml, No. 1	Concentrate for preparation of solution for infusions	0.85	0.35	0.14	0.07	1
11	Cislkyu spal 20, 20mg/20ml, No. 1	The same	0.85	0.35	0.14	0.07	1
12	Cislkyu spal 50, 50mg/50ml, No. 1	// – //	0.93	0.31	0.19	0.07	1
13	Cisplatin, 1mg/ml, No. 1	// – //	0.73	0.32	0.28	0.08	1
14	Cisplatin, 10mg/10ml, 10ml, No. 1	// – //	0.93	0.22	0.18	0.03	1
15	Cisplatin, 50mg/50ml, 50ml, No. 1	// – //	0.69	0.14	0.59	0.18	1
16	Cisplatin, 100mg/100ml, 100ml, No. 1	// – //	0.78	0.17	0.43	0.26	1
17	Cisplatin-kelun-kazfarm, 50mg/50ml, 50 ml, No. 1	// – //	0.80	0.31	0.22	0.11	1

 

Table 1 shows the cisplatin used in non-small cell lung adenocarcinoma according to 17 trade names belonging to the international unpatented name Cisplatin. Cisplatin ebeve® 50mg/100ml was found to be the most effective medicines with the results 0-5.5 points - 0.01, 5.6-7.0 points - 0.64, 7.1-8.5 points - 0.00, 8.6-10 points - 1.00.

 

Table 2: Efficacy rates of carboplatin international non-proprietary name medicines in non-small cell lung adenocarcinoma

S. No.	International non-proprietary name / Trade names	Medicine form	0–5.5	5.6–7.0	7.1–8.5	8.6–10	Program Evaluation
1	Carboplatin-ebeve®, 150mg/15ml	Concentrate for preparation of solution for infusions	0.61	0.10	0.16	0.69	4
2	Carboplatin-ebeve®, 450mg/45ml	The same	0.49	0.00	0.21	0.91	4
3	Adcarb, 150mg/15ml	// – //	0.65	0.23	0.76	0.11	3
4	Karbo spal™ 150, 150mg/15ml, 15 ml	// – //	0.40	0.23	0.66	0.08	3
5	Karbo spal™ 450, 450mg/45ml, 45 ml	// – //	0.58	0.19	0.61	0.13	3
6	Chemocarb, 10mg/ml, 15ml, No. 1	// – //	0.67	0.19	1.00	0.00	3
7	Chemocarb, 10mg/ml, 45ml, No. 1	// – //	0.64	0.28	0.91	0.01	3
8	Carboplatin-naprod, 150mg/15ml, 15 ml	Concentrate for preparation of solution for intravenous infusions	0.26	0.96	0.41	0.12	2
9	Carboplatin-naprod, 450mg/45ml, 45 ml	The same	0.25	1.00	0.40	0.18	2
10	Adcarb, 450mg/45ml	Concentrate for preparation of solution for infusions	0.67	0.26	0.61	0.14	1
11	Carbodex, 50mg/5ml	The same	0.77	0.23	0.70	0.02	1
12	Carbodex, 450mg/45ml	// – //	0.73	0.18	0.63	0.08	1
13	Karboxti®, 150mg, No. 1	Lyophilized powder for preparation of solution for injection	0.67	0.24	0.62	0.13	1
14	Carboplatin, 10mg/ml, No. 1	The same	1.00	0.27	0.25	0.24	1
15	Carboplatin, 50mg/5ml, 5ml, No. 1	// – //	0.99	0.45	0.32	0.21	1
16	Carboplatin, 150mg/15ml, 15ml, No. 1	// – //	0.53	0.35	0.21	0.28	1
17	Carboplatin, 450mg/45ml, 45ml, No. 1	// – //	0.40	0.25	0.16	0.36	1
18	Carboplatin, 600mg/60ml, 60ml, No. 1	// – //	0.72	0.33	0.38	0.21	1
19	Carboplatin-ebeve®, 10mg/ml	// – //	0.89	0.27	0.42	0.22	1
20	Carboplatin-ebeve®, 50mg/5ml	// – //	0.91	0.37	0.32	0.26	1
21	Carbotin™, 150mg/15ml, 15ml	// – //	0.64	0.33	0.43	0.19	1
22	Carbotin™, 450mg/45ml, 45ml	// – //	0.66	0.37	0.40	0.17	1

 

In Table 2, Carboplatin-ebeve®, 150mg/15ml and Carboplatin-ebeve®, 450mg/45ml trade name medicines belonging to the international non-patented name of carboplatin used in non-small cell lung adenocarcinoma were highly effective, 5 were effective, 2 were less effective, and 13 were poorly effective.

 

Table 3: Efficacy indicators of pemetrexed, gemcitabine international non-proprietary name medicines used in non-small cell lung adenocarcinoma

S. No.	International non-proprietary name / Trade names	Medicine form	0–5.5	5.6–7.0	7.1–8.5	8.6–10	Program Evaluation
1	Pemdjem, 100mg, No. 1	Lyophilizate for preparation of solution for infusions	0.12	0.78	0.00	0.87	4
2	Pemdjem, 500mg, No. 1	The same	0.00	0.65	0.10	1.00	4
3	Pemetrexed, 500mg, No. 1	Lyophilized powder for preparation of solution for infusions	0.00	0.65	0.22	0.83	4
4	Adpem, 100mg	Lyophilized powder for preparation of infusion solution	0.42	1.00	0.05	0.14	2
5	Adpem, 500mg	The same	0.24	1.00	0.51	0.14	2
6	Pemex, 500mg, No. 1, No. 4	Lyophilizate for preparation of solution for injection	0.16	0.76	0.34	0.46	2
7	Gemcitabine Ebeve® 1000 mg/25ml	Concentrate for preparation of solution for infusions	0.07	0.79	0.04	0.85	4
8	Acvitabine, 200mg, No. 1	Powder for preparation of solution for infusions	0.28	0.87	0.30	0.20	2
9	Gembio, 200mg	The same	0.31	0.85	0.31	0.20	2
10	Aquitabine, 1000mg, No. 1	–	0.31	0.85	0.31	0.20	2
11	Amgitsin, 200mg	Lyophilized powder for preparation of infusion solution	0.31	0.82	0.34	0.21	2
12	Amgitsin, 1000mg	The same	0.30	0.85	0.39	0.20	2
13	Gembio, 1g	// – //	0.26	0.91	0.41	0.33	2
14	Gemita, 200mg, No. 1	Lyophilizate for preparation of solution for infusions	0.21	0.95	0.51	0.19	2
15	Gemita, 1g, No. 1	The same	0.23	0.97	0.64	0.14	2
16	Gemtero, 200mg, No. 1	// – //	0.22	0.96	0.28	0.17	2
17	Gemtero, 1g, No. 1	// – //	0.30	0.84	0.26	0.20	2
18	Gemcyt™, 200mg	// – //	0.30	0.81	0.47	0.20	2
19	Hemcyt™, 1g	// – //	0.23	0.81	0.43	0.27	2
20	Gemcitabine Ebeve®, 40mg/ml	Concentrate for preparation of solution for infusions	0.22	0.93	0.20	0.30	2
21	Gemcitabine, 100mg/ml, No. 1	The same	0.24	0.85	0.43	0.26	2
22	Gemcitabine Ebeve®, 200mg/5 ml	// – //	0.14	0.82	0.17	0.51	2
23	Gemcitabine Ebeve®, 2000 mg/50ml	// – //	0.20	0.96	0.29	0.25	2
24	Gemcitabine-Naprod, 200mg	Lyophilized powder for preparation of solution for intravenous infusion	0.25	1.00	0.42	0.18	2
25	Gemcitabine-Naprod, 1g	The same	0.24	0.96	0.19	0.22	2
26	Gemcitabine, 200mg, No. 1, No. 40	Powder for preparation of solution for infusions	0.20	0.88	0.36	0.24	2
27	Gemcitabine, 1000mg, No. 1, No. 20	The same	0.19	0.92	0.32	0.19	2
28	Gemcitabine, 200mg/2ml, 2ml, No. 1	// – //	0.26	0.97	0.32	0.15	2
29	Gemcitabine, 1000mg/10ml, 10 ml, No. 1	// – //	0.22	0.98	0.33	0.19	2
30	Selzar™, 200mg	Lyophilized powder for preparation of infusion solution	0.92	0.45	0.45	0.07	1
31	Selzar™, 1000mg	The same	0.92	0.44	0.45	0.09	1

 

In Table 3, pemetrexed, used in non-small cell (adenocarcinoma) lung cancer, 3 of the 6 trade names belonging to the international non-patented name Pemetrexed, were medicines with high efficacy. Gemcitabine, used in non-small cell (adenocarcinoma) lung cancer, is 1 of 25 trade name medicines belonging to the international non-patented name, Gemcitabine Ebeve®, 1000 mg/25 ml, high-performance medicines.

 

Table 4: Efficacy rates of etoposide, vinorelbine international non-proprietary name medicines in non-small cell lung adenocarcinoma

No.	International non-proprietary name / Trade names	Medicine form	0–5.5	5.6–7.0	7.1–8.5	8.6–10	Program evaluation
1	Etoposide ebeve®, 100mg/5 ml	Concentrate for preparation of solution for infusions	0.27	0.15	0.35	0.87	4
2	Etoposide ebeve®, 200mg/10 ml	The same	0.40	0.04	1.00	0.03	3
3	Phytozid, 100mg/5ml, 5ml, No. 1	// – //	0.19	0.50	0.47	0.01	2
4	Etoposide-Naprod, 100mg/5ml, 5 ml	Concentrate for preparation of solution for intravenous infusions	0.51	0.98	0.10	0.01	2
5	Etolon, 100, 100mg/5ml, 5ml	Concentrate for preparation of solution for infusions	1.00	0.21	0.17	0.00	1
6	Etoposide ebeve®, 20mg/ml	The same	0.65	0.02	0.34	0.02	1
7	Etoposide ebeve®, 50mg/2.5ml	// – //	0.67	0.23	0.29	0.04	1
8	Etoposide ebeve®, 400mg/20ml	// – //	0.75	0.02	0.33	0.08	1
9	Vinorelbine ebeve®, 10mg/1ml, 1 ml, No. 1	Concentrate for preparation of solution for infusions	0.05	0.00	1.00	0.00	3
10	Vinorelbin-Kelunkazfarm, 10mg/1 ml, No. 1	The same	0.18	0.00	0.45	0.00	3
11	Vinorelbin-Kelunkazfarm, 50mg/5 ml, 5ml, No. 1	// – //	0.18	0.00	0.45	0.00	3
12	Vinorelbine ebeve®, 50mg/5ml, 5 ml, No. 1	// – //	1.00	0.00	0.36	0.00	1

 

In Table 4, trade name Etopozide ebeve® 100mg/5ml etoposide is a highly effective medicines among the international non-patented names. Three medicines belonging to the international non-patented name of Vinorelbine showed average efficiency.

 

Table 5: Efficacy rates of international non-proprietary name paclitaxel in non-small cell lung adenocarcinoma

No.	International non-proprietary name / Trade names	Medicine form	0–5.5	5.6–7.0	7.1–8.5	8.6–10	Program Evaluation
1	Paclitaxel ebeve®, 30 mg/5 ml	Concentrate for preparation of solution for infusions	0.09	0.45	0.25	0.58	4
2	Paclitaxel ebeve®, 100 mg/16.7 ml	The same	0.08	0.24	0.31	0.50	4
3	Paclitaxel ebeve®, 300 mg/50 ml	// – //	0.11	0.33	0.11	0.99	4
4	Paclitaxel, 30 mg/5 ml, No. 1, No. 40	// – //	0.25	0.89	0.30	0.06	2
5	Paclitaxel, 100 mg/16.7 ml, No. 1, No. 40	// – //	0.13	0.52	0.34	0.32	2
6	Ab-pakli, 100 mg	Lyophilized powder for preparation of suspension for infusions	0.41	0.89	0.27	0.06	2
7	Adpaxel, 30 mg/5 ml, 5 ml	Concentrate for preparation of solution for infusions	0.40	0.88	0.22	0.08	2
8	Adpaxel, 100 mg/16.7 ml, 16.7 ml	The same	0.39	0.87	0.19	0.10	2
9	Adpaxel, 260 mg/43.4 ml, 43.4 ml	// – //	0.41	0.90	0.18	0.09	2
10	Intaxel, 30 mg/5 ml, #1	// – //	0.40	0.99	0.15	0.02	2
11	Ataxil, 100 mg/16.7 ml, No. 1	Concentrate for preparation of solution for intravenous infusions	0.36	0.86	0.18	0.12	2
12	Intaxel, 100 mg/16.7 ml, No. 1	The same	0.16	0.55	0.19	0.36	2
13	Intaxel, 260 mg/43.4 ml, No. 1	// – //	0.10	0.60	0.10	0.46	2
14	Paclitaxel ebeve®, 6 mg/ml	// – //	0.16	0.46	0.21	0.35	2
15	Paclitaxel, 100 mg/16.7 ml, No. 1	// – //	0.16	0.52	0.30	0.32	2
16	Paclitaxel, 300 mg/50 ml, No. 1	// – //	0.09	0.41	0.17	0.40	2
17	Paclitaxel-Naprod, 30 mg/5 ml	Solution for injection	0.24	0.91	0.32	0.06	2
18	Paclitaxel-Naprod, 100 mg/16.67 ml	The same	0.31	0.97	0.36	0.00	2
19	Paclitaxel-Naprod, 260 mg/43.34 ml	// – //	0.17	0.70	0.28	0.29	2
20	Paclitaxel-kelun-kazfarm, 30 mg/5 ml, No. 1	Concentrate for preparation of solution for infusions	0.86	0.60	0.24	0.04	1
21	Paclitaxel-kelun-kazfarm, 60 mg/10 ml, No. 1	The same	0.82	0.58	0.26	0.06	1
22	Paclitaxel-kelun-kazfarm, 100 mg/16.7 ml, No. 1	// – //	0.82	0.29	0.27	0.06	1
23	Paclitaxel, 6 mg/ml, 16.7 ml	// – //	0.87	0.58	0.22	0.05	1
24	Paclitaxel, 6 mg/ml, 50 ml	// – //	0.88	0.57	0.20	0.04	1
25	Paclitaxel, 6 mg/ml, No. 1	// – //	0.89	0.62	0.24	0.03	1
26	Paclitaxel, 30 mg/5 ml, No. 1	// – //	1.00	0.34	0.20	0.01	1

In Table 5, 3 trade name medicines belonging to the international non-patented name paclitaxel used in non-small cell lung adenocarcinoma were highly effective, 16 were less effective and 7 were poorly effective medicines.

 

Table 6: Efficacy rates of docetaxel international non-proprietary name in non-small cell lung adenocarcinoma

No.	International non-proprietary name / Trade names	Medicine form	0–5.5	5.6–7.0	7.1–8.5	8.6–10	Program Evaluation
1	Docetaxel Ebeve®, 10 mg/ml	Concentrate for preparation of solution for infusions	0.33	0.47	0.21	1.00	4
2	Docetaxel Ebeve®, 20mg/2 ml	The same	0.05	0.42	0.20	0.74	4
3	Docetaxel Ebeve®, 80mg/8 ml	// – //	0.07	0.54	0.07	0.70	4
4	Docetaxel, 20mg/ml, 1ml, No. 1	// – //	0.49	0.67	0.13	0.04	2
5	Docetaxel, 20mg/ml, 2ml, No. 1	// – //	0.46	0.60	0.08	0.13	2
6	Docetaxel, 20mg/ml, 4ml, No. 1	// – //	0.40	0.75	0.07	0.08	2
7	Adoxy, 20mg/0.5ml, complete with solvent - ethyl alcohol 96%, 1.5 ml	Solution for injection	0.22	0.58	0.27	0.35	2
8	Adoxy, 80mg/2.0ml, complete with solvent - ethyl alcohol 96%, 6.0 ml	The same	0.22	0.61	0.26	0.36	2
9	Adoxy, 120mg/3.0ml, complete with solvent - ethyl alcohol 96%, 9.0ml	// – //	0.22	0.65	0.25	0.33	2
10	Daxotel, 20mg/ml, No. 1	Concentrate for preparation of solution for infusions	0.26	0.86	0.13	0.08	2
11	Daxotel, 80mg/4 ml, No. 1	The same	0.22	0.81	0.20	0.15	2
12	Donataxel, 20mg, No. 1	// – //	0.22	0.83	0.11	0.15	2
13	Doceter, 20mg/ml, 1ml, No. 1	// – //	0.21	0.68	0.24	0.12	2
14	Donataxel, 80mg, No. 1	// – //	0.22	0.96	0.18	0.23	2
15	Docetaxel-Naprod, 20mg/0.5 ml	Concentrate for preparation of infusion solution for intravenous administration	0.23	0.85	0.25	0.00	2
16	Docetaxel-Naprod, 80mg/2 ml	The same	0.04	1.00	0.42	0.04	2
17	Docetaxel-Naprod, 120mg/3 ml	// – //	0.10	0.78	0.28	0.08	2
18	Doceter, 80mg/4ml, 4ml, No. 1	// – //	0.13	0.66	0.30	0.41	2
19	Selter™ 20, 20mg, No. 1	// – //	0.09	0.76	0.31	0.15	2
20	Selter™ 80, 80mg, No. 1	// – //	0.14	0.82	0.29	0.14	2
21	Taxotere®, 20mg/1 ml	// – //	0.20	0.60	0.01	0.34	2
22	Taxotere®, 80mg/4 ml	// – //	0.25	0.72	0.00	0.26	2
23	Docetaxel-Kelun-Kazfarm, 20 mg/1ml, No. 1	// – //	0.79	0.43	0.13	0.16	1
24	Docetaxel-Kelun-Kazfarm, 40 mg/ml, No. 1	// – //	0.74	0.45	0.18	0.17	1
25	Docetaxel-Kelun-Kazfarm, 80 mg/4ml, No. 1	// – //	1.00	0.34	0.13	0.34	1

 

In Table 6, 3 trade name medicines of international non-patented name docetaxel used in non-small cell (adenocarcinoma) lung cancer were highly effective, 19 were less effective and 3 were poorly effective medicines.

 

Table 7: Efficacy rates of international non-proprietary name, Bevacizumab, Erlotinib hydrochloride, Erlotinib in non-small cell lung adenocarcinoma

No.	International non-proprietary name / Trade names	Medicine form	0–5.5	5.6–7.0	7.1–8.5	8.6–10	Program Evaluation
1	Avastin®, 100mg/4 ml	Concentrate for preparation of solution for infusions	0.05	0.02	0.00	0.80	4
2	Avastin®, 400mg/16 ml	The same	0.00	0.00	0.00	1.00	4
3	Avegra®, 25mg/ml, 16 ml No. 1	// – //	0.53	0.98	1.00	0.16	3
4	Avegra®, 25mg/ml, 0.5 ml, No. 1	// – //	0.44	0.97	0.40	0.02	2
5	Avegra®, 25mg/ml, 4 ml No. 1	// – //	0.41	1.00	0.72	0.23	2
6	Bivaas, 25mg/ml	Concentrate for preparation of solution for injection	0.31	0.92	0.51	0.00	2
7	Bivaas, 100 mg/4 ml	The same	0.29	0.92	0.51	0.00	2
8	Bivaas, 400 mg/16 ml	// – //	0.29	0.91	0.49	0.02	2
9	Erlonib, 25 mg, No. 30	Film coated tablets	0.30	0.73	0.41	0.99	4
10	Erlonix, 100 mg, No. 30	The same	0.00	0.32	0.80	0.87	4
11	Ertinob, 100 mg, No. 30	Coated tablets	0.00	0.32	0.80	0.87	4
12	Ertinob, 150 mg, No. 30	The same	0.00	0.32	0.80	0.87	4
13	Erlonix, 150 mg, No. 30	Film coated tablets	0.00	0.32	1.00	0.87	3
14	Erlonib, 100 mg, No. 30	The same	0.15	1.00	0.47	0.87	2
15	Erlonib, 150 mg, No. 30	// – //	0.15	1.00	0.47	0.87	2
16	Ertinob®, 100 mg, No. 30	// – //	0.00	0.00	0.38	1.00	4
17	Ertinob®, 150 mg, No. 30	// – //	0.00	0.00	0.58	0.11	3

 

In Table 7, non-patented international name bevacizumab used in non-small cell lung adenocarcinoma was highly effective in 2 out of 8 trade names, 1 was effective and 5 were less effective. Erlotinib hydrochloride used in non-small cell lung adenocarcinoma was the top 4 of the 7 trade names belonging to the international non-patented name were highly effective, 1 was effective and 2 were less effective. 1 trade name out of 2 non-patented international name erlotinib was highly effective and 1 was effective.

 

DISCUSSION:

This study evaluated the economic and clinical effectiveness of commonly used therapies for non-small cell lung cancer (NSCLC), including Cisplatin (50 mg/100ml), Carboplatin (150mg/15ml), Gemcitabine (1000mg/25ml), Etoposide (100mg/5ml), Vinorelbine (10mg/1 ml and 50mg/5ml), Docetaxel (20mg/2ml, 80 mg/8 ml), Pemetrexed, Bevacizumab, and Erlotinib¹⁹. Clinical observations and patient questionnaires indicated consistency between the reported subjective experiences and objective treatment outcomes, supporting the reliability of the data¹⁹. Our findings align with previous studies conducted in Thailand, where pemetrexed and cisplatin demonstrated the highest total cost but slightly better life years and Quality-Adjusted Life Years (QALY)²⁰. In second-line treatment settings, pembrolizumab was more cost-effective compared with docetaxel, although nivolumab remained expensive at baseline²¹. Drugs such as Cisplatin, Carboplatin, Pemetrexed, and Gemcitabine were effective in slowing disease progression²². Systemic drug therapy managed by pulmonologists and oncologists plays a critical role in monitoring NSCLC patients, allowing treatments to be tailored based on complete pharmacological information²³. Medications like Erlotinib hydrochloride, which target specific histological and molecular tumor characteristics, showed outcomes consistent with their expected mechanisms of action²⁴. Among the evaluated drugs, Cisplatin (Cisplatin Ebeve®), Carboplatin (Carboplatin Ebeve®), Pemetrexed (Pemdjem), Gemcitabine (Gemcitabine Ebeve®), Etoposide (Etoposide Ebeve®), Paclitaxel (Paclitaxel Ebeve®), Docetaxel (Docetaxel Ebeve®), Bevacizumab (Avastin®), and Erlotinib (Erlonib, Ertinob®) were identified as highly effective^19,24. This study had several limitations. The analysis did not stratify effectiveness by disease stage, nor were therapies evaluated according to standardized treatment sequences. Previous research has addressed these aspects²⁵. Nevertheless, as pharmacists supplying state-provided medications, our focus was to assess effectiveness based on specific trade names to inform public procurement and optimize NSCLC treatment strategies^13,23.

 

CONCLUSIONS:

The effectiveness of medicines used in non-small-cell lung adenocarcinoma (NSCLC) was evaluated based on form and dosage across 10 international non-patented names and 150 trade names. Using an intellectual analysis method, 21 medicines were identified as highly effective, 13 as effective, 77 as moderately effective, and 39 as low-effectiveness. These findings allowed the prioritization of medicines for clinical use, supporting the production of generics for highly effective drugs and their importation using state funds. The study provides guidance for optimal procurement strategies to ensure efficient and effective treatment of NSCLC patients.

 

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Received on 24.09.2025      Revised on 29.12.2025 Accepted on 05.03.2026      Published on 20.05.2026 Available online from May 25, 2026 Research J. Pharmacy and Technology. 2026;19(5):2171-2178. DOI: 10.52711/0974-360X.2026.00313 © RJPT All right reserved
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