Cost-minimisation analysis in first-line treatment of metastatic colorectal cancer in France: XELOX versus FOLFOX-6

Oncology. 2010;79(3-4):174-80. doi: 10.1159/000325999. Epub 2011 Feb 28.

Abstract

Objective: In a recent randomized study, we demonstrated that XELOX (oxaliplatin + oral capecitabine) was well tolerated and not inferior in terms of efficacy to the infusional FOLFOX-6 regimen in first-line treatment of metastatic colorectal cancer (mCRC). The objective of this additional analysis was to compare the cost of XELOX and FOLFOX-6.

Methods: This cost-minimisation study took into account costs related to drug acquisition, hospital care for chemotherapy administration and for serious adverse event management. Hospital care costs were based on French 'diagnosis-related group' tariffs. Drug acquisition costs were drawn from French official sources. Analysis was performed from the French health insurance perspective.

Results: Baseline characteristics of the 282 patients included (143 XELOX, 139 FOLFOX-6) were well balanced. Patients reported less and shorter hospitalisations (day and overnight hospital care) with XELOX: 6.4 ± 2.2 hospitalisations versus 9.7 ± 3.1 (p < 0.001); 11.4 ± 10.6 days versus 17.7 ± 11.8 (p < 0.001). Mean disease management cost per patient was significantly lower with XELOX (EUR 12,918 ± 5,075 vs. EUR 17,229 ± 8,665, p < 0.001).

Conclusion: In the perspective of our analysis, taking into account hospitalisation and drug acquisition costs, the treatment of mCRC patients with XELOX in comparison to FOLFOX-6 significantly decreased the costs, as well as the mean overall hospitalisation length of stay.

Publication types

  • Clinical Trial, Phase III
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / economics*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Capecitabine
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / economics*
  • Colorectal Neoplasms / pathology
  • Cost of Illness
  • Costs and Cost Analysis
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / economics
  • Deoxycytidine / therapeutic use
  • Female
  • Fluorouracil / analogs & derivatives
  • Fluorouracil / economics
  • Fluorouracil / therapeutic use
  • Health Care Costs
  • Humans
  • Leucovorin / economics
  • Leucovorin / therapeutic use
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / economics*
  • Liver Neoplasms / secondary
  • Male
  • Middle Aged
  • Organoplatinum Compounds / economics
  • Organoplatinum Compounds / therapeutic use
  • Oxaloacetates
  • Prospective Studies
  • Survival Rate
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Oxaloacetates
  • Deoxycytidine
  • Capecitabine
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol
  • XELOX