Abstract
The objective of this study was to evaluate the cost implications of different settings (inpatient, outpatient/day clinic, or office-based oncologists) for the administration of standard fluoropyrimidine therapies, i.e., Mayo Clinic and Arbeitsgemeinschaft Internistische Onkologie (AIO)/Ardalan regimen, and to compare the results with the cost of oral capecitabine in Germany. In total, 89 quarterly fee-listings from 26 patients provided by 5 office-based oncologists were analyzed. Physician’s services, drug costs, pharmacy costs, and costs for implantable venous port systems and single-use pumps were considered. Findings were transferred to the hospital setting. A third-party payer perspective was applied. Quarterly treatment costs for the Mayo Clinic regimen varied between € 2,036 and € 10,569, and between € 1,294 and € 10,179 for the AIO/Ardalan regimen depending on the treatment setting. Projected costs for capecitabine were € 2,338. No hospitalization was considered to be necessary for capecitabine due to its oral administration route. The most expensive treatment options were the AIO/Ardalan protocol in the office-based setting and the Mayo Clinic protocol in the hospital setting. Capecitabine emerged as the cheapest option in the office-based setting. Overall, the cheapest option was the AIO/Ardalan protocol in municipal hospitals. However, municipal hospitals are unlikely to cover their costs in this situation. Substantial cost savings without incurring losses to providers may be realized if patients are transferred from the hospital setting to the office-based setting and treated with capecitabine.
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References
Robert-Koch-Institut, Berlin, Germany (2003) http://www.rki.de/gbe/krebs/krebs.htm. Cited 20 Oct 2003
Jonker DJ, Maroun JA, Kocha W (2002) Survival benefit of chemotherapy in metastatic colorectal cancer: a meta-analysis of randomized controlled trials. Br J Cancer 82:1789–1794
Grothey A, Kellermann L, Schmoll HJ (2002) Defizite in der Behandlung von Patienten mit kolorektalem Karzinom in Deutschland. Med Klin 97:270–277
Twelves C, Xeloda Study Group (2002) Capecitabine as first-line treatment in colorectal cancer. Pooled data from two large, phase III trials. Eur J Cancer 38[Suppl 2]:15–20
Herold M, Sacchi S, Hieke K (2002) The cost of treating relapsed indolent Non-Hodgkin’s Lymphoma in an international setting: retrospective analysis of resource use. Haematologica 87:719–729
Herold M, Hieke K (2003) Costs of drug delivery for CHOP, COP/CVP and fludarabine: an international assessment. Value Health 6:167–174
Twelves C, Boyer M, Findlay M, et al (2001) Capecitabine (Xeloda™) improves medical resource use compared with 5-fluorouracil plus leucovorin in a phase III trial conducted in patients with advanced colorectal carcinoma. Eur J Cancer 37:597–604
NICE (National Institute for Clinical Excellence) UK (2003) Final appraisal determination—capecitabine and tegafur with uracil for metastatic colorectal cancer. http://www.nice.org.uk/pdf/FAD_capecitabineacolorectalcancer.pdf. Cited March 2003
Hieke K, Twelves C, Boyer M (2000) Economic consequences of differences in the adverse-events (AE)-profile of capecitabine vs. Mayo Clinic-regimen in previously untreated advanced/metastatic colorectal cancer. Value Health 3:351
Cassidy J, Twelves C, Van Cutsem E, et al (2002) First-line oral capecitabine therapy in metastatic colorectal cancer: a favorable safety profile compared with intravenous 5-fluorouracil/leucovorin. Ann Oncol 13:566–575
Liu G, Franssen E, Fitch MI, et al (1997) Patient preferences for oral versus intravenous palliative chemotherapy. J Clin Oncol 15:110–115
Borras JM, Sanchez-Hernandez A, Navarro M, et al (2001) Compliance, satisfaction, and quality of life of patients with colorectal cancer receiving home chemotherapy or outpatient treatment: a randomised controlled trial. BMJ 322:1–5
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Hieke, K., Kleeberg, U.R., Stauch, M. et al. Costs of treatment of colorectal cancer in different settings in Germany. Eur J Health Econom 5, 270–273 (2004). https://doi.org/10.1007/s10198-003-0220-3
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DOI: https://doi.org/10.1007/s10198-003-0220-3