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Article: Cost-analysis of XELOX and FOLFOX4 for treatment of colorectal cancer to assist decision-making on reimbursement
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TitleCost-analysis of XELOX and FOLFOX4 for treatment of colorectal cancer to assist decision-making on reimbursement
 
AuthorsTse, VC1
Ng, WT2
Lee, V1
Lee, AWM2
Chua, DTT1
Chau, J1
McGhee, SM1
 
Issue Date2011
 
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/
 
CitationBmc Cancer, 2011, v. 11 [How to Cite?]
DOI: http://dx.doi.org/10.1186/1471-2407-11-288
 
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.
 
ISSN1471-2407
2012 Impact Factor: 3.333
2012 SCImago Journal Rankings: 1.331
 
DOIhttp://dx.doi.org/10.1186/1471-2407-11-288
 
PubMed Central IDPMC3146941
 
ISI Accession Number IDWOS:000293270000001
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.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorTse, VC
 
dc.contributor.authorNg, WT
 
dc.contributor.authorLee, V
 
dc.contributor.authorLee, AWM
 
dc.contributor.authorChua, DTT
 
dc.contributor.authorChau, J
 
dc.contributor.authorMcGhee, SM
 
dc.date.accessioned2011-09-23T05:58:33Z
 
dc.date.available2011-09-23T05:58:33Z
 
dc.date.issued2011
 
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.
 
dc.description.naturepublished_or_final_version
 
dc.identifier.citationBmc Cancer, 2011, v. 11 [How to Cite?]
DOI: http://dx.doi.org/10.1186/1471-2407-11-288
 
dc.identifier.citeulike9547055
 
dc.identifier.doihttp://dx.doi.org/10.1186/1471-2407-11-288
 
dc.identifier.eissn1471-2407
 
dc.identifier.hkuros192538
 
dc.identifier.hkuros186297
 
dc.identifier.isiWOS:000293270000001
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.

 
dc.identifier.issn1471-2407
2012 Impact Factor: 3.333
2012 SCImago Journal Rankings: 1.331
 
dc.identifier.pmcidPMC3146941
 
dc.identifier.pmid21740590
 
dc.identifier.scopuseid_2-s2.0-79959944866
 
dc.identifier.urihttp://hdl.handle.net/10722/139855
 
dc.identifier.volume11
 
dc.languageeng
 
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofBMC Cancer
 
dc.relation.referencesReferences in Scopus
 
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 reimbursement
 
dc.typeArticle
 
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<description.abstract>Background: 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. &#169; 2011 Tse et al; licensee BioMed Central Ltd.</description.abstract>
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<subject.mesh>Adenocarcinoma - drug therapy - economics</subject.mesh>
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Author Affiliations
  1. The University of Hong Kong
  2. Pamela Youde Nethersole Eastern Hospital