Cost-effectiveness analysis of colon cancer treatments from MOSIAC and No.16968 trials

• Published in: 世界胃肠病学杂志：英文版（电子版） no. 47; pp. 17976 - 17984
• Main Author: Feng Wen Ke Yao Ze-Dong Du Xiao-Feng He Peng-Fei Zhang Rui-Lei Tang Qiu Li
• Format: Journal Article
• Language: English
• Published: 2014
• Subjects: Adjuvant; can; chemotherapy; Colon; Cost-effectiveness
• ISSN: 1007-9327; 2219-2840

AIM:To compare XELOX and FOLFOX4 as colon cancer adjuvant chemotherapy based on MOSAIC and No.16968 trails from Chinese cost-effectiveness perspective.METHODS:A decision-analytic Markov model was developed to compare the FOLFOX4 and XELOX regimens based MOSAIC and No.16968 trial.Five states were included in our Markov model:well(state 1),minor toxicity(state 2),major toxicity(state 3),quitting adjuvant chemotherapy(state 4),and death due to adjuvant chemotherapy(state 5).Transitions among the 5 states were assumed to be Markovian.Costs were calculated from the perspective of the Chinese health-care payer.The utility data were taken from published studies.Sensitivity analyses were used to explore the impact of uncertainty factors in this cost-effectiveness analysis.RESULTS:Total direct costs of FOLFOX4 and XELOX per patient were$19884.96±4280.30 and$18113.25±3122.20,respectively.The total fees related to adverse events per patient during the entire treatment were$204.75±16.80 for the XELOX group,and$873.72±27.60 for the FOLFOX4 group,and the costs for travel and absenteeism per patient were$18495.00for the XELOX group and$21,352.68 for the FOLFOX4group.The base-case analysis showed that FOLFOX4was estimated to produce an additional 0.06 in quality adjusted life years(QALYs)at an additional cost of$3950.47 when compared to the XELOX regimen over the model time horizon.The cost per QALY gained was$8047.30 in the XELOX group,which was$900.98 less than in the FOLFOX4 group($8948.28).The one way sensitivity analysis demonstrated that the utility for the well state and minor toxicity state greatly influenced the incremental cost-effectiveness ratio of FOLFOX4.CONCLUSION:In term of cost-comparison,XELOX is expected to dominate FOLFOX4 regimes;Therefore,XELOX provides a more cost-effective adjuvant chemotherapy for colon cancer patients in China.