title: Real-world resource use and costs of adjuvant treatment for stage III colon cancer.
abstract: Since the generalisability of trial-based economic evaluations may be limited, there is an increasing focus on real-world cost-effectiveness. Real-world studies involve evaluating the effects and costs of treatments in daily clinical practice. This study reports on the real-world resource use and costs of adjuvant treatments of stage III colon cancer in a population-based observational study. Analyses were based on a detailed retrospective medical chart review which was conducted for 206 patients with colon cancer treated in 2005 and 2006 in the Netherlands. Mean total costs per patient were €9681 for 5-FU/LV, €9736 for capecitabine, €32,793 for FOLFOX and €18,361 for CAPOX. Drug costs and the costs related to hospitalisations for chemotherapy administration were the main cost drivers. We identified a potential for substantial cost-savings when the 48 h administration of 5FU/LV in the FOLFOX regimen were to take place in an outpatient setting or be replaced by oral capecitabine as in the CAPOX regimen. This analysis based on detailed real-life data clearly indicates that clinical choices made in oncology based on efficacy of therapy have economic consequences. Considering today's reality of finite healthcare resources, these economic consequences deserve a formal role in clinical decision making, for instance in guideline development.
authors.affiliation: Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam.
authors.forename: C W M
authors.initials: CW
authors.lastname: van Gils
authors.forename: S
authors.initials: S
authors.lastname: de Groot
authors.forename: S S
authors.initials: SS
authors.lastname: Tan
authors.forename: W K
authors.initials: WK
authors.lastname: Redekop
authors.forename: M
authors.initials: M
authors.lastname: Koopman
authors.forename: C J A
authors.initials: CJ
authors.lastname: Punt
authors.forename: C A
authors.initials: CA
authors.lastname: Uyl-de Groot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000191:economics*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics; D017024:Chemotherapy, Adjuvant / Q000191:economics*; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000473:pathology; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016522:Oncology Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: chemotherapy; colon cancer; costs; real-world