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Article: Cost-analysis of XELOX and FOLFOX4 for treatment of colorectal cancer to assist decision-making on reimbursement

TitleCost-analysis of XELOX and FOLFOX4 for treatment of colorectal cancer to assist decision-making on reimbursement
Authors
Issue Date2011
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/
Citation
Bmc Cancer, 2011, v. 11 How to Cite?
AbstractBackground: XELOX (capecitabine + oxaliplatin) and FOLFOX 4 (5-FU + folinic acid + oxaliplatin) have shown similar improvements in survival in patients with metastatic colorectal cancer (MCRC). A US cost-minimization study found that the two regimens had similar costs from a healthcare provider perspective but XELOX had lower costs than FOLFOX4 from a societal perspective, while a Japanese cost-effectiveness study found XELOX had superior cost-effectiveness. This study compared the costs of XELOX and FOLFOX4 in patients with MCRC recently treated in two oncology departments in Hong Kong.Methods: Cost data were collected from the medical records of 60 consecutive patients (30 received XELOX and 30 FOLFOX4) from two hospitals. Drug costs, outpatient visits, hospital days and investigations were recorded and expressed as cost per patient from the healthcare provider perspective. Estimated travel and time costs were included in a societal perspective analysis. All costs were classed as either scheduled (associated with planned chemotherapy and follow-up) or unscheduled (unplanned visits or admissions and associated tests and medicines). Costs were based on government and hospital sources and expressed in US dollars (US$).Results: XELOX patients received an average of 7.3 chemotherapy cycles (of the 8 planned cycles) and FOLFOX4 patients received 9.2 cycles (of the 12 planned cycles). The scheduled cost per patient per cycle was $2,046 for XELOX and $2,152 for FOLFOX4, while the unscheduled cost was $240 and $421, respectively. Total treatment cost per patient was $16,609 for XELOX and $23,672 for FOLFOX4; the total cost for FOLFOX4 was 37% greater than that of XELOX. The addition of the societal costs increased the total treatment cost per patient to $17,836 for XELOX and $27,455 for FOLFOX4. Sensitivity analyses showed XELOX was still less costly than FOLFOX4 when using full drug regimen costs, incorporating data from a US model with costs and adverse event data from their clinical trial and with the removal of oxaliplatin from both treatment arms. Capecitabine would have to cost around four times its present price in Hong Kong for the total resource cost of treatment with XELOX to equal that of FOLFOX4.Conclusion: XELOX costs less than FOLFOX4 for this patient group with MCRC from both the healthcare provider and societal perspectives. © 2011 Tse et al; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/139855
ISSN
2014 Impact Factor: 3.362
2014 SCImago Journal Rankings: 1.403
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Miller Medical Communications UK
Roche Hong Kong
Funding Information:

The authors also acknowledge that medical editing/writing support was provided by Miller Medical Communications UK. The medical writing/editing support was funded by Roche Hong Kong.

References

 

DC FieldValueLanguage
dc.contributor.authorTse, VCen_HK
dc.contributor.authorNg, WTen_HK
dc.contributor.authorLee, Ven_HK
dc.contributor.authorLee, AWMen_HK
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorChau, Jen_HK
dc.contributor.authorMcGhee, SMen_HK
dc.date.accessioned2011-09-23T05:58:33Z-
dc.date.available2011-09-23T05:58:33Z-
dc.date.issued2011en_HK
dc.identifier.citationBmc Cancer, 2011, v. 11en_HK
dc.identifier.issn1471-2407en_HK
dc.identifier.urihttp://hdl.handle.net/10722/139855-
dc.description.abstractBackground: XELOX (capecitabine + oxaliplatin) and FOLFOX 4 (5-FU + folinic acid + oxaliplatin) have shown similar improvements in survival in patients with metastatic colorectal cancer (MCRC). A US cost-minimization study found that the two regimens had similar costs from a healthcare provider perspective but XELOX had lower costs than FOLFOX4 from a societal perspective, while a Japanese cost-effectiveness study found XELOX had superior cost-effectiveness. This study compared the costs of XELOX and FOLFOX4 in patients with MCRC recently treated in two oncology departments in Hong Kong.Methods: Cost data were collected from the medical records of 60 consecutive patients (30 received XELOX and 30 FOLFOX4) from two hospitals. Drug costs, outpatient visits, hospital days and investigations were recorded and expressed as cost per patient from the healthcare provider perspective. Estimated travel and time costs were included in a societal perspective analysis. All costs were classed as either scheduled (associated with planned chemotherapy and follow-up) or unscheduled (unplanned visits or admissions and associated tests and medicines). Costs were based on government and hospital sources and expressed in US dollars (US$).Results: XELOX patients received an average of 7.3 chemotherapy cycles (of the 8 planned cycles) and FOLFOX4 patients received 9.2 cycles (of the 12 planned cycles). The scheduled cost per patient per cycle was $2,046 for XELOX and $2,152 for FOLFOX4, while the unscheduled cost was $240 and $421, respectively. Total treatment cost per patient was $16,609 for XELOX and $23,672 for FOLFOX4; the total cost for FOLFOX4 was 37% greater than that of XELOX. The addition of the societal costs increased the total treatment cost per patient to $17,836 for XELOX and $27,455 for FOLFOX4. Sensitivity analyses showed XELOX was still less costly than FOLFOX4 when using full drug regimen costs, incorporating data from a US model with costs and adverse event data from their clinical trial and with the removal of oxaliplatin from both treatment arms. Capecitabine would have to cost around four times its present price in Hong Kong for the total resource cost of treatment with XELOX to equal that of FOLFOX4.Conclusion: XELOX costs less than FOLFOX4 for this patient group with MCRC from both the healthcare provider and societal perspectives. © 2011 Tse et al; licensee BioMed Central Ltd.en_HK
dc.languageengen_US
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/en_HK
dc.relation.ispartofBMC Canceren_HK
dc.rightsBMC Cancer. Copyright © BioMed Central Ltd.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAdenocarcinoma - drug therapy - economics-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols - administration and dosage - economics - therapeutic use-
dc.subject.meshColorectal Neoplasms - drug therapy - economics-
dc.subject.meshHealth Care Costs - statistics and numerical data-
dc.subject.meshInsurance, Health, Reimbursement - economics-
dc.titleCost-analysis of XELOX and FOLFOX4 for treatment of colorectal cancer to assist decision-making on reimbursementen_HK
dc.typeArticleen_HK
dc.identifier.emailLee, V: vhflee@hku.hken_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailMcGhee, SM: smmcghee@hkucc.hku.hken_HK
dc.identifier.authorityLee, V=rp00264en_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.identifier.authorityMcGhee, SM=rp00393en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/1471-2407-11-288en_HK
dc.identifier.pmid21740590-
dc.identifier.pmcidPMC3146941-
dc.identifier.scopuseid_2-s2.0-79959944866en_HK
dc.identifier.hkuros192538en_US
dc.identifier.hkuros186297-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79959944866&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume11en_HK
dc.identifier.eissn1471-2407-
dc.identifier.isiWOS:000293270000001-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTse, VC=44761602200en_HK
dc.identifier.scopusauthoridNg, WT=36787043300en_HK
dc.identifier.scopusauthoridLee, V=14035860900en_HK
dc.identifier.scopusauthoridLee, AWM=17035384900en_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridChau, J=36941253500en_HK
dc.identifier.scopusauthoridMcGhee, SM=7003288588en_HK
dc.identifier.citeulike9547055-

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