Cassidy, J and Douillard, Y and Twelves, C and McKendrick, JJ and Scheithauer, W and Bustova, I and Johnston, PG and Lesniewski-Kmak, L and Jelic, S and Fountzilas, G and Coxon, F and Diaz-Rubio, E and Maughan, TS and Malzyner, A and Bertetto, O and Beham, A and Figer, A and Dufour, P and Patel, KK and Cowell, W and Garrison, LP (2006) Pharmacoeconomic analysis of adjuvant oral capecitabine vs intravenous 5-FU/LV in Dukes' C colon cancer: the X-ACT trial. BRITISH JOURNAL OF CANCER, 94 (8). pp. 1122-1129. ISSN 0007-0920,
Full text not available from this repository. (Request a copy)Abstract
Oral capecitabine (Xeloda (R)) is an effective drug with favourable safety in adjuvant and metastatic colorectal cancer. Oxaliplatinbased therapy is becoming standard for Dukes' C colon cancer in patients suitable for combination therapy, but is not yet approved by the UK National Institute for Health and Clinical Excellence (NICE) in the adjuvant setting. Adjuvant capecitabine is at least as effective as 5-fluorouracil/leucovorin (5-FU/LV), with significant superiority in relapse-free survival and a trend towards improved disease-free and overall survival. We assessed the cost-effectiveness of adjuvant capecitabine from payer (UK National Health Service (NHS)) and societal perspectives. We used clinical trial data and published sources to estimate incremental direct and societal costs and gains in quality-adjusted life months (QALMs). Acquisition costs were higher for capecitabine than 5-FU/LV, but higher 5-FU/LV administration costs resulted in 57% lower chemotherapy costs for capecitabine. Capecitabine vs 5-FU/LV-associated adverse events required fewer medications and hospitalisations (cost savings 3653) pound. Societal costs, including patient travel/time costs, were reduced by > 75% with capecitabine vs 5-FU/LV (cost savings 1318) pound, with lifetime gain in QALMs of 9 months. Medical resource utilisation is significantly decreased with capecitabine vs 5-FU/LV, with cost savings to the NHS and society. Capecitabine is also projected to increase life expectancy vs 5-FU/LV. Cost savings and better outcomes make capecitabine a preferred adjuvant therapy for Dukes' C colon cancer. This pharmacoeconomic analysis strongly supports replacing 5-FU/LV with capecitabine in the adjuvant treatment of colon cancer in the UK.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 5-FLUOROURACIL PLUS LEUCOVORIN; PHASE-III TRIAL; COST-EFFECTIVENESS; COLORECTAL-CANCER; BREAST-CANCER; FLUOROURACIL; CHEMOTHERAPY; EFFICACY; CARCINOMA; RECOMMENDATIONS; capecitabine; 5-fluorouracil/leucovorin; adjuvant; colon cancer; pharmacoeconomics; cost-effectiveness |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Feb 2021 05:56 |
| Last Modified: | 16 Feb 2021 05:56 |
| URI: | https://pred.uni-regensburg.de/id/eprint/34656 |
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