Capecitabine plus docetaxel combination therapy: Cost-effectiveness in patients with anthracycline-pretreated advanced breast carcinoma

Article Abstract:

Original ArticleDisease SiteBreast DiseaseCapecitabine plus docetaxel combination therapy: Cost-effectiveness in patients with anthracycline-pretreated advanced breast carcinoma (p 2455-2465) Shailendra Verma, Dominique Maraninchi, Joyce O'Shaughnessy, Carol Jamieson, Stephen Jones, Miguel Martin, Joseph McKendrick, David Miles, Chris Twelves, John Hornberger capecitabine o docetaxel o metastatic breast carcinoma o cost o pharmacoeconomics o cost benefit Abstract BACKGROUND For patients with anthracycline-pretreated metastatic breast carcinoma, capecitabine plus docetaxel significantly increased overall survival compared with docetaxel alone. The current study evaluated the cost-effectiveness of the capecitabine/docetaxel combination versus docetaxel monotherapy, comparing the gain in quality-adjusted survival with associated health care costs. METHODS Patients were randomized to receive 21-day cycles of oral capecitabine 1250 mg/m2 twice daily, on Days 1-14, plus docetaxel 75 mg/m2 Day 1 (n = 255), or docetaxel 100 mg/m2 on Day 1 (n = 256). Health and cost outcomes in the two arms were compared, and cost-effectiveness was estimated. Data on survival time and medical care resource use were prospectively collected in the trial. Costs associated with medical care resource use and quality-of-life adjustments were obtained from the published literature. The incremental cost-effectiveness ratio was calculated as the cost per quality-adjusted life year (QALY) gained. RESULTS Capecitabine/docetaxel increased the median overall survival by 3 months compared with docetaxel alone (14.5 vs. 11.5 months). The mean quality-adjusted survival was increased by 1.8 months in the capecitabine/docetaxel group. The total medical-resource utilization cost per patient was 8.9% higher with the combination: $24,475 for combination therapy versus $22,477 for single-agent docetaxel. The mean cost per QALY gained with combination therapy was $13,558 (standard deviation, $6742). Cost savings due to reduced docetaxel dose and hospital use were the major cost offsets with the combination. Sensitivity analyses showed that varying the mean hospital cost per day from the 5th to the 95th percentile resulted in cost-utility ratios ranging from $20,326 to as low as $6360. CONCLUSIONS Capecitabine/docetaxel was a cost-effective treatment in patients with anthracycline-pretreated advanced breast carcinoma, and had an incremental cost-effectiveness ratio that compares very favorably with that of many other oncology therapies. Cancer 2005. [c] 2005

Canada, France, Commodity & service prices, Economic aspects, Prices and rates, Comparative analysis, Breast cancer, Anthracyclines, Company pricing policy, Capecitabine (Medication), docetaxel (Medication)

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Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia

Article Abstract:

A cross-sectional analysis of data from a national colonoscopy-based screening program for colorectal cancer in Poland was conducted with an objective to derive and validate a model for the detection of advanced neoplasia in the large bowel during screening colonoscopy. A significantly higher rate of advanced neoplasia was detected in men than in women, which might warrant refinement of the screening recommendations for colorectal cancer.

Care and treatment, Diagnosis, Colorectal cancer, Colonoscopy

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Capecitabine as adjuvant treatment for stage III colon cancer

Article Abstract:

Survival advantages of fluorouracil-based adjuvant chemotherapy in reducing the risk of relapse and prolonging survival in patients with respected colon are demonstrated. The findings indicate that oral capecitabine is an effective alternative to intravenous fluorouracil plus leucovorin in the adjustment treatment of colon cancer.

United Kingdom, Risk factors, Dosage and administration, Fluorouracil, Leucovorin, Folinic acid, Colon cancer

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