Cost consequences of adjuvant capecitabine, Mayo Clinic and de Gramont regimens for stage III colon cancer in the French setting.
OBJECTIVE
To compare the cost consequences of oral capecitabine and two different intravenous regimens of 5-fluorouracil/folinic acid (de Gramont and Mayo Clinic regimens) as adjuvant therapy in stage III colon cancer in France.


METHODS
Clinical efficacy and safety data were taken from published clinical trials. Medical resource use was estimated from published data and expert opinion. Direct costs (drug acquisition, inpatient and home drug administration, laboratory tests, transportation, and management of adverse events) were considered over a time horizon of 46 months (3.8 years). The perspective taken was that of the French Sickness Funds.


RESULTS
In patients treated with capecitabine, relapse-free survival was 1.3 months longer than with the Mayo Clinic regimen, which has been shown to be as effective as the de Gramont regimen. In the base case analysis, capecitabine was less costly (3,654 EUR/patient) than the Mayo Clinic (10,481 EUR/ patient) and de Gramont (7,204 EUR/patient) regimens. In the sensitivity analysis, capecitabine remained dominant except when the intravenous regimens were assumed to be administered at home in all patients.


CONCLUSIONS
In France, capecitabine is more effective and less costly than both the Mayo Clinic and de Gramont regimens as adjuvant therapy for colon cancer.
Douillard
J Y
JY
Centre René Gauducheau, Nantes, France.
Tilleul
P
P
Ychou
M
M
Dufour
P
P
Perrocheau
G
G
Seitz
J F
JF
Maes
P
P
Lafuma
A
A
Husseini
F
F
D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D005472:Fluorouracil / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D005602:France; D006801:Humans; D002955:Leucovorin / Q000191:economics / Q000627:therapeutic use; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D003841:Deoxycytidine; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil