Cost identification of Nordic FLIRI, Nordic FLOX, XELIRI and XELOX in first-line treatment of advanced colorectal cancer in Sweden – A clinical practice model approach

Pettersson, Karin; Carlsson, Göran; Holmberg, C.; Sporrong, Sofia Kälvemark

doi:10.3109/0284186x.2012.713507

Cited by 10 publications

(3 citation statements)

References 16 publications

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“…[12] As adverse effects contribute to extensive resource use in hospital, it is important that these costs are considered. [13] Our study, like that of Lan et al, [12] showed that costs of treatment are reduced when breast cancer is diagnosed at an early stage and that age at diagnosis did not significantly influence the cost of treatment.…”

Section: Researchsupporting

confidence: 77%

Development of a method to determine the cost of breast cancer treatment with chemotherapy at Groote Schuur Hospital, Cape Town, South Africa

et al. 2020

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Breast cancer is one of the major healthcare challenges in South Africa (SA). Data published by the National Cancer Registry [1] in 2014 showed that breast cancer represented 22% of all cancers affecting women in SA, making it the most prevalent cancer affecting women in this country. Understanding the total cost of care for breast cancer is important from a health funder perspective, i.e. policymakers and hospital administration, in budget allocation and in decision-making [2] in a resource-constrained environment. Objectives To develop a method to determine the cost of breast cancer treatment with chemotherapy per episode of care and to quantify the associated costs relating to chemotherapy at Groote Schuur Hospital (GSH), a tertiary government hospital in Western Cape Province, SA. These costs included costs associated with the management of adverse events arising from chemotherapy. Methods Study design A retrospective cohort analysis was performed to determine the cost of an episode of care for treatment of breast cancer with chemotherapy. Cost estimates for an episode of care were obtained for each stage of breast cancer. The episode of care was defined as the care provided from 2 months prior to the date of commencing chemotherapy (pre-chemotherapy phase), during chemotherapy (treatment phase) and until 6 months after the date when the last cycle of chemotherapy was administered (follow-up phase). The episode of care was on average a period of 10-12 months per patient. Participants A total of 1 024 patients were extracted from the electronic database. Two hundred patients were randomly selected using a random number generator. Patients were included in the study based on the following criteria: (i) a diagnosis of breast cancer; (ii) registration date at the oncology department from 1 April 2013 to 31 March 2015; (iii) evidence of receipt of chemotherapy with two or more health encounters [3] related to breast cancer, e.g. doctor consultation in oncology ward and a mammogram; and (iv) age ≥18 years. Patients were excluded from the study based on the following criteria: (i) male; (ii) initiated on hormone therapy but not chemotherapy; (iii) enrolled in a clinical trial; and (iv) a primary diagnosis of cancer that was not breast cancer. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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Section: Researchsupporting

confidence: 77%

Development of a method to determine the cost of breast cancer treatment with chemotherapy at Groote Schuur Hospital, Cape Town, South Africa

et al. 2020

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“…treatment with 5-FU typically requires the use of indwelling catheters, pumps for continuous infusion and several hospital visits by the patient or home visits by medical personnel, capecitabine is self-administered orally. Thus, the use of 5-FU would be expected to result in increased health care service utilization associated with treatment administration compared with capecitabine [ 5 – 12 ], as well as the costs to the patient for traveling to, and remaining at the hospital for treatment [ 6 , 10 , 11 , 13 ]. Given these differences in the mode of administration and potential accessibility of treatment, several studies have noted a preference by patients for capecitabine over 5-FU on the basis of convenience [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Impacting Treatment Choice in the First-Line Treatment of Colorectal Cancer

et al. 2016

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IntroductionTo investigate the factors that affect the choice of 5-fluorouracil (5-FU) or its oral alternative, capecitabine, as first-line treatment in patients with colorectal cancer (CRC).MethodsPatients treated with 5-FU or capecitabine for CRC between January 1, 2011 and December 31, 2013 in a teaching hospital in the Sydney metropolitan area, Australia were identified using the hospital’s database MOSAIQ®. The electronic medical record of each patient was manually reviewed to extract factors potentially affecting treatment choice. Logistic regression was used to assess which patient and/or treatment factors could explain the choice between 5-FU or capecitabine. Where it was available in the medical correspondence, the explicit reason for the choice made was extracted.Results170 CRC patients were included; 119 on 5-FU, and 51 on capecitabine. The odds of receiving capecitabine as a first-line treatment were positively associated with giving patients a choice in the decision (OR = 17.51, 95% CI: 5.37–57.08). Qualitative data suggest treatment choices were motivated by convenience (oral administration) and tolerability. Time from diagnosis to treatment commencement (OR = 1.02 per month, 95% CI 1.00–1.04) was also found to be positively associated with the choice of capecitabine. The odds of being treated with capecitabine were lower for patients who lived further from the treating hospital (OR = 0.22, 95% CI 0.05–0.94).ConclusionThis study suggests that patient choice, favoring oral capecitabine over i.v. 5-FU, was a key factor influencing first-line treatment for CRC in this cohort. To respect their autonomy, patients should be involved in the clinical decision making process.Electronic supplementary materialThe online version of this article (doi:10.1007/s40487-016-0020-4) contains supplementary material, which is available to authorized users.

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“…14–17 Chemotherapy agents and targeted therapies are listed among the most expensive medical interventions contributing to a projection of more than $17 billion annual cost of CRC treatment in 2020. 18 Therefore, there is a growing interest in the medical community to analyze the cost-effectiveness of existing and emerging chemotherapy regimens for mCRC 19–29 and to identify those patients that survive with reasonable cost and higher quality of life. Majority of these analyses focus on the cost-effectiveness of single regimen when administered at a particular line of treatment.…”

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confidence: 99%

Comparative Effectiveness of Up To Three Lines of Chemotherapy Treatment Plans for Metastatic Colorectal Cancer

Toumazis

Kurt

Toumazi

et al. 2017

MDM Policy & Practice

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Modern chemotherapy agents transformed standard care for metastatic colorectal cancer (mCRC) but raised concerns about the financial burden of the disease. We studied comparative effectiveness of treatment plans that involve up to three lines of therapies and impact of treatment sequencing on health and cost outcomes. We employed a Markov model to represent the dynamically changing health status of mCRC patients and used Monte-Carlo simulation to evaluate various treatment plans consistent with existing guidelines. We calibrated our model by a meta-analysis of published data from an extensive list of clinical trials and measured the effectiveness of each plan in terms of cost per quality-adjusted life year. We examined the sensitivity of our model and results with respect to key parameters in two scenarios serving as base case and worst case for patients’ overall and progression-free survivals. The derived efficient frontiers included seven and five treatment plans in base case and worst case, respectively. The incremental cost-effectiveness ratio (ICER) ranged between $26,260 and $152,530 when the treatment plans on the efficient frontiers were compared against the least costly efficient plan in the base case, and between $21,256 and $60,040 in the worst case. All efficient plans were expected to lead to fewer than 2.5 adverse effects and on average successive adverse effects were spaced more than 9 weeks apart from each other in the base case. Based on ICER, all efficient treatment plans exhibit at least 87% chance of being efficient. Sensitivity analyses show that the ICERs were most dependent on drug acquisition cost, distributions of progression-free and overall survivals, and health utilities. We conclude that improvements in health outcomes may come at high incremental costs and are highly dependent in the order treatments are administered.

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Cost identification of Nordic FLIRI, Nordic FLOX, XELIRI and XELOX in first-line treatment of advanced colorectal cancer in Sweden – A clinical practice model approach

Cited by 10 publications

References 16 publications

Development of a method to determine the cost of breast cancer treatment with chemotherapy at Groote Schuur Hospital, Cape Town, South Africa

Development of a method to determine the cost of breast cancer treatment with chemotherapy at Groote Schuur Hospital, Cape Town, South Africa

Factors Impacting Treatment Choice in the First-Line Treatment of Colorectal Cancer

Comparative Effectiveness of Up To Three Lines of Chemotherapy Treatment Plans for Metastatic Colorectal Cancer

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