title: Medical care consumption in a phase III trial comparing irinotecan with infusional 5-fluorouracil (5-FU) in patients with metastatic colorectal cancer after 5-FU failure.
abstract: We evaluated economic implications of treatment with irinotecan, following a RCT which demonstrated significantly increased survival at 1 year with irinotecan (45%) compared to infusional 5-fluorouracil (5-FU) (32%) in patients with metastatic colorectal cancer. Medical care consumption data were collected prospectively alongside the trial, with 256 patients followed for a median of 10 months. Follow-up was prolonged beyond treatment failure and medical care consumption was not protocol driven, enabling a realistic evaluation of economic implications. Medical care consumption associated with chemotherapy administration was lower with irinotecan as compared with infusional 5-FU. The cumulative number of days in hospital due to treatment toxicity and cancer complications, which is the key cost driver, was 14.4 (95% CI: 10.7-18.1) with irinotecan versus 17.5 (95% CI: 11.7-23.3) with infusional 5-FU. Thus, the survival benefit with second-line irinotecan compared to infusional 5-FU in patients with advanced colorectal cancer was achieved without increasing medical care consumption.
authors.affiliation: ARCOS, Issy-les-Moulineaux, France. cschmitt@arcos.fr
authors.forename: C
authors.initials: C
authors.lastname: Schmitt
authors.forename: G
authors.initials: G
authors.lastname: Blijham
authors.forename: B
authors.initials: B
authors.lastname: Jolain
authors.forename: P
authors.initials: P
authors.lastname: Rougier
authors.forename: E
authors.initials: E
authors.lastname: Van Cutsem
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D002166:Camptothecin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000191:economics* / Q000473:pathology; D005472:Fluorouracil / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D000077146:Irinotecan; D007902:Length of Stay / Q000191:economics; D009362:Neoplasm Metastasis; D011446:Prospective Studies; D016019:Survival Analysis; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin