title: Cost-minimisation analysis in first-line treatment of metastatic colorectal cancer in France: XELOX versus FOLFOX-6.
abstract: OBJECTIVE
  In a recent randomized study, we demonstrated that XELOX (oxaliplatin + oral capecitabine) was well tolerated and not inferior in terms of efficacy to the infusional FOLFOX-6 regimen in first-line treatment of metastatic colorectal cancer (mCRC). The objective of this additional analysis was to compare the cost of XELOX and FOLFOX-6.
  
  
  METHODS
  This cost-minimisation study took into account costs related to drug acquisition, hospital care for chemotherapy administration and for serious adverse event management. Hospital care costs were based on French 'diagnosis-related group' tariffs. Drug acquisition costs were drawn from French official sources. Analysis was performed from the French health insurance perspective.
  
  
  RESULTS
  Baseline characteristics of the 282 patients included (143 XELOX, 139 FOLFOX-6) were well balanced. Patients reported less and shorter hospitalisations (day and overnight hospital care) with XELOX: 6.4 ± 2.2 hospitalisations versus 9.7 ± 3.1 (p < 0.001); 11.4 ± 10.6 days versus 17.7 ± 11.8 (p < 0.001). Mean disease management cost per patient was significantly lower with XELOX (EUR 12,918 ± 5,075 vs. EUR 17,229 ± 8,665, p < 0.001).
  
  
  CONCLUSIONS
  In the perspective of our analysis, taking into account hospitalisation and drug acquisition costs, the treatment of mCRC patients with XELOX in comparison to FOLFOX-6 significantly decreased the costs, as well as the mean overall hospitalisation length of stay.
authors.affiliation: Centre René Gauducheau, Centre d'investigation clinique, Saint-Herblain, France. g-perrocheau@nantes.fnclcc.fr
authors.forename: G
authors.initials: G
authors.lastname: Perrocheau
authors.forename: J
authors.initials: J
authors.lastname: Bennouna
authors.forename: M
authors.initials: M
authors.lastname: Ducreux
authors.forename: M
authors.initials: M
authors.lastname: Hebbar
authors.forename: M
authors.initials: M
authors.lastname: Ychou
authors.forename: G
authors.initials: G
authors.lastname: Lledo
authors.forename: T
authors.initials: T
authors.lastname: Conroy
authors.forename: S
authors.initials: S
authors.lastname: Dominguez
authors.forename: R
authors.initials: R
authors.lastname: Faroux
authors.forename: V
authors.initials: V
authors.lastname: Florentin
authors.forename: J Y
authors.initials: JY
authors.lastname: Douillard
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000473:pathology; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D002955:Leucovorin / Q000191:economics / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000191:economics / Q000627:therapeutic use; D010071:Oxaloacetates; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil