University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, 94115, USA.
Am J Clin Oncol. 2010 Dec;33(6):550-6. doi: 10.1097/COC.0b013e3181c06f94.
Capecitabine may have a higher acquisition cost compared with other select chemotherapy agents; however, its use is not associated with many of the costs typically encountered with intravenous chemotherapy, such as costs incurred through administration procedures and the management of subsequent tolerability issues. This study compared the cost of capecitabine- and taxane-based regimens in the treatment of breast cancer.
Thomson Reuters MarketScan, a US employer claims database, was used to identify patients with a breast cancer diagnosis between 2000 and 2005 and at least one chemotherapy claim or hormone treatment in 2004 or 2005.
Cost data for treatment administration and management of selected chemotherapy-related adverse events were collected. Multivariate analyses were performed to adjust for differences in patient demographic and clinical factors.
A total of 3630 patients were included in this analysis; 4216 treatment episodes were recorded. Mean unadjusted total monthly expenditures were lowest for capecitabine regimens compared with taxane plus anthracycline or other taxane regimens ($8445 vs. $13,295 and $12,323, respectively; P < 0.0001). The adjusted total monthly cost for capecitabine regimens was lower than the cost for taxane plus anthracycline regimen ($10,895 vs. $13,115) and other taxane regimens ($9253 vs. $12,116). Adjusted complication costs for taxane treatment episodes were almost double than those seen with capecitabine ($5509 for anthracycline plus taxane vs. $2940, and $3829 for other taxane regimens vs. $1750).
Lower complication-related expenditures with capecitabine therapy accounted for majority of the cost differential seen in comparison with taxane-based therapy.
与其他选择化疗药物相比,卡培他滨的购置成本可能更高;然而,与静脉化疗相关的许多成本(如管理后续耐受性问题的成本)并不包括卡培他滨的使用成本。本研究比较了卡培他滨和紫杉烷类药物治疗乳腺癌的成本。
利用美国雇主索赔数据库 Thomson Reuters MarketScan,确定 2000 年至 2005 年期间患有乳腺癌的患者,并在 2004 年或 2005 年至少有一次化疗或激素治疗的索赔。
收集选定化疗相关不良反应治疗管理的成本数据。进行多变量分析以调整患者人口统计学和临床因素的差异。
共有 3630 名患者纳入本分析;记录了 4216 次治疗。与紫杉烷加蒽环类或其他紫杉烷方案相比,卡培他滨方案的未经调整的每月总支出最低(分别为 8445 美元、13295 美元和 12323 美元;P<0.0001)。卡培他滨方案的调整后每月总成本低于紫杉烷加蒽环类方案(10895 美元比 13115 美元)和其他紫杉烷方案(9253 美元比 12116 美元)。紫杉烷治疗方案的并发症成本调整后几乎是卡培他滨的两倍(紫杉烷加蒽环类方案为 5509 美元,卡培他滨为 2940 美元;其他紫杉烷方案为 3829 美元,卡培他滨为 1750 美元)。
卡培他滨治疗相关并发症支出较低,这在与紫杉烷类药物治疗相比时,是造成成本差异的主要原因。