Cost-utility analysis of adjuvant chemotherapy in patients with stage III colon cancer in Thailand

Expert Rev Pharmacoecon Outcomes Res. 2015;15(4):687-700. doi: 10.1586/14737167.2015.972379. Epub 2014 Oct 18.

Abstract

Background: In Thailand, there has been no economic evaluation study of adjuvant chemotherapy for stage III colon cancer patients after resection.

Objective: This study aims to evaluate the cost-utility of all chemotherapy regimens currently used in Thailand compared with the adjuvant 5-fluorouracil/leucovorin (5-FU/LV) plus capecitabine as the first-line therapy for metastatic disease in patients with stage III colon cancer after resection.

Methods: A cost-utility analysis was performed to estimate the relevant lifetime costs and health outcomes of chemotherapy regimens based on a societal perspective using a Markov model.

Results: The results suggested that the adjuvant 5-FU/LV plus capecitabine as the first-line therapy for metastatic disease would be the most cost-effective chemotherapy.

Conclusions: The adjuvant FOLFOX and FOLFIRI as the first-line treatment for metastatic disease would be cost-effective with an incremental cost-effectiveness ratio of 299,365 Thai baht per QALY gained based on a societal perspective if both prices of FOLFOX and FOLFIRI were decreased by 40%.

Keywords: Thailand; adjuvant chemotherapy; cost-utility analysis; oxaliplatin; stage III colon cancer.

Publication types

  • Comparative Study

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / economics
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Capecitabine / administration & dosage
  • Chemotherapy, Adjuvant / economics
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / economics
  • Colonic Neoplasms / pathology
  • Cost-Benefit Analysis
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Leucovorin / administration & dosage
  • Male
  • Markov Chains
  • Middle Aged
  • Neoplasm Staging
  • Quality-Adjusted Life Years
  • Thailand

Substances

  • Capecitabine
  • Leucovorin
  • Fluorouracil