Financial impact of oral vinorelbine use in a regional hospital

Abstract

Background The advantages of orally active chemotherapy make it a valuable option for treating cancer patients. Purpose To assess the use and cost of oral vinorelbine (OV) in a regional hospital. Materials and methods A retrospective descriptive study carried out from January 2009 till September 2010. The authors report on all the patients who were treated with OV during the period of study. The authors checked the following information: sex, age, diagnosis, previous and subsequent chemotherapy regimens, chemotherapy regimen, mean dose, patient-related cost and overall cost. Results The authors studied 21 patients (80.9% men and 19.1% women) with a mean age of 68.1±8.9 years. 15 patients were diagnosed with non-small cell lung cancer (NSCLC), 3 with breast cancer (BC) and 3 with prostate cancer (PC). 40% of patients with NSCLC had previously been treated with cisplatin-paclitaxel or cisplatin-gemcitabine whereas 60% had been treated with cisplatin-vinorelbine or vinorelbine alone. With regard to the other diagnoses: 3 patients with BC had been treated with paclitaxel-anthracycline and 3 patients with PC had been treated with paclitaxel-carboplatin. For the current treatment, the distribution of treatments was the following: a) OV monotherapy (6), b) OV associated with cisplatin (6), c) docetaxel monotherapy (2) and c) without treatment (7). The chemotherapy regimens with OV were: 60 mg/m2, on the 1st and 8th day every 21 days (71.4%); 60 mg/m2, on the 1st and 8th day every 21 days the first cycle and 80 mg/m2, on the 1st and 8th day every 21 days in the following cycles (14.3%); 60 mg/m2, on days 1, 8 and 15 every 28 days (14.3%). Average dose of OV was 110.4±13.6 mg with an average number of prescriptions dispensed of 4.7±2.7. Only 9 patients had received prior intravenous vinorelbine. Patient-related cost was 1,314.08 € and overall cost was 14,454.96 €. Conclusions In our hospital, OV was used in accordance with the guidelines except that the absence of intravenous vinorelbine first in 42.8% of patients should be justified. Although the cost of OV is high it is justifiable because it avoids indirect costs.