The CAP-CR study: Direct medical costs in Italian metastatic colorectal cancer patients on first-line infusional 5-fluorouracil or oral capecitabine

Lopatriello, Stefania; Amoroso, Domenico; Donati, Sara; Alabiso, Oscar; Forti, L.; Fornasiero, A.; Smergo, A.; Lalli, Angelo; Iacono, Carmelo; Lucenti, Ausiliatrice; D'Alonzo, Lidia; Negrini, C

doi:10.1016/j.ejca.2008.08.010

Cited by 13 publications

(13 citation statements)

References 16 publications

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“…Another English study added that capecitabine allowed medical staff to gain 10 h of work per treated patient [29]. The same conclusions were established in Italy [30,31,32] and in the Netherlands [33]. As we showed that the XELOX protocol reduced the number of chemotherapy administrations and the hospital length of stay compared to the FOLFOX-6 protocol, we could expect that medical staff work time and hospital resources could probably be saved with XELOX.…”

Section: Discussionsupporting

confidence: 59%

Cost-Minimisation Analysis in First-Line Treatment of Metastatic Colorectal Cancer in France: XELOX versus FOLFOX-6

Perrocheau¹,

Bennouna²,

Ducreux

et al. 2010

Oncology

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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.

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Section: Discussionsupporting

confidence: 59%

Cost-Minimisation Analysis in First-Line Treatment of Metastatic Colorectal Cancer in France: XELOX versus FOLFOX-6

Perrocheau¹,

Bennouna²,

Ducreux

et al. 2010

Oncology

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“…5-FU in the adjuvant and metastatic disease settings. 29,30,39,42,[44][45][46] The cost savings have been primarily driven by the need to administer 5-FU on an inpatient basis, but capecitabine was also associated with decreased costs of adverse side effect management. Similarly, XELOX is at least cost-saving compared with FOLFOX, with any improved clinical efficacy being modest.…”

Section: Discussionmentioning

confidence: 99%

“…The oral administration of capecitabine as opposed to administration in-hospital for 5-FU, is a major driver for metastatic disease analyses. Cost and medical resource utilization studies that compared capecitabine monotherapy with 5-FU in the metastatic setting [44][45][46] have shown potential cost savings with capecitabine, similar to the adjuvant setting.…”

Section: Cea Studies In the Metastatic Disease Settingmentioning

confidence: 95%

Cost-Effectiveness of Adjuvant Chemotherapy in the Treatment of Early-Stage Colon Cancer

Soni

Chu

2015

Clinical Colorectal Cancer

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“…An Italian study compared the costs for patients involved in a clinical study comparing capecitabine with 5-FU in single therapy, estimating a saving of €823 per patient over 6 months of treatment, with a cost driver represented by the cost of chemotherapy in the capecitabine arm and by infusion in the 5-FU arm 10,12. A recent retrospective study carried out in France estimated a saving of €2000–€7200, depending on the 5-FU chemotherapy regime 13.…”

Section: Discussionmentioning

confidence: 99%

Economic comparison of capecitabine + oxaliplatin and 5-fluorouracil + oxaliplatin in the adjuvant treatment of colon cancer

Aitini

Rossi²,

Morselli³

et al. 2012

CMAR

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BackgroundColorectal cancer is one of the most frequent and lethal cancers. The aim of this study was to analyze the costs relating to treatment of colorectal cancer between Xelox and Folfox-4 at a regional level according to the clinical experience at an Italian hospital in Lombardy.MethodsA cost analysis was carried out regarding resource consumption by patients suffering from colorectal cancer based on data collected over a 12-month period between 2010 and 2011. The analysis involved 40 patients who attended the Department of Medical Oncology and Hematology at Carlo Poma Hospital to undergo adjuvant therapy for colorectal cancer. A chart was created for each patient containing their medical history, their pharmacological therapy indicating the number and duration of chemotherapy cycles, dose in mg administered for each cycle, number of day hospital visits for each cycle, number of days spent in hospital to position the central vein catheter, type of infusion pump used, any subsequent supportive therapy, and any side effects and outpatient visits connected with side effects.ResultsThe cost analysis shows the savings involved in using Xelox for a single cycle of treatment, ie, approximately €1414.00 per patient (53% compared with Folfox-4). For each single cycle of treatment, the savings generated by using capecitabine compared with 5-FU can be attributed mostly to the fact that oral administration of chemotherapy requires fewer resources and does not require use of a central vein catheter (approximately 70% of overall cost) which amply compensates for the higher cost of capecitabine compared with 5-FU-LV. Sensibility analysis confirms the results of the base-case scenario.ConclusionThe results of our study indicate that infusion via a central vein catheter represents a significant cost, and that substitution with an oral therapy, even when associated with drugs administered intravenously, represents a consistent saving of hospital resources.

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The CAP-CR study: Direct medical costs in Italian metastatic colorectal cancer patients on first-line infusional 5-fluorouracil or oral capecitabine

Cited by 13 publications

References 16 publications

Cost-Minimisation Analysis in First-Line Treatment of Metastatic Colorectal Cancer in France: XELOX versus FOLFOX-6

Cost-Minimisation Analysis in First-Line Treatment of Metastatic Colorectal Cancer in France: XELOX versus FOLFOX-6

Cost-Effectiveness of Adjuvant Chemotherapy in the Treatment of Early-Stage Colon Cancer

Economic comparison of capecitabine + oxaliplatin and 5-fluorouracil + oxaliplatin in the adjuvant treatment of colon cancer

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