Ho Maria Y, Chang Albert Y, Ruan Jenny Y, Cheung Winson Y
Division of Medical Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.
Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Clin Colorectal Cancer. 2016 Jun;15(2):158-63. doi: 10.1016/j.clcc.2015.09.004. Epub 2015 Sep 30.
Evidence suggests that CAPOX (capecitabine and oxaliplatin) has efficacy similar to 5-fluorouracil and oxaliplatin (mFOLFOX6) in the adjuvant treatment of colon cancer. CAPOX is partly administered orally and associated with a 3-week rather than a 2-week treatment cycle. A population-based cost-minimization analysis was conducted from the health care payer and societal perspectives to evaluate the potential cost savings of replacing mFOLFOX6 with CAPOX.
We applied treatment and toxicity data from phase III trials of CAPOX and FOLFOX-based regimens to the adjuvant colon cancer population in British Columbia, Canada. In this cost-minimization analysis we compared the total costs associated with chemotherapy medications, drug administration and delivery, hospital and clinic visits, treatment-related toxicities, and central venous access devices. Costs to patients in terms of lost time and travel were also considered. It was assumed that patients would receive either 8 cycles of CAPOX or 12 cycles of mFOLFOX6.
From the payer perspective, the use of CAPOX resulted in cost savings of $5339 CAD per patient compared with the use of mFOLFOX6. From a societal perspective, CAPOX was also associated with savings of $6080 CAD per patient. The greatest cost savings with CAPOX were attributed to fewer visits for chemotherapy treatment and decreased central venous access device usage. CAPOX was also associated with reduced loss of time and decreased travel for patients because of the requirement of fewer clinic visits.
Replacement of mFOLFOX6 with CAPOX in the adjuvant treatment of colon cancer might be associated with potential cost savings from the payer and societal perspectives.
有证据表明，卡培他滨联合奥沙利铂（CAPOX）在结肠癌辅助治疗中的疗效与5-氟尿嘧啶联合奥沙利铂（mFOLFOX6）相似。CAPOX部分为口服给药，治疗周期为3周而非2周。从医疗保健支付方和社会角度进行了一项基于人群的成本最小化分析，以评估用CAPOX替代mFOLFOX6可能节省的成本。
我们将CAPOX和基于FOLFOX方案的III期试验中的治疗和毒性数据应用于加拿大不列颠哥伦比亚省的结肠癌辅助治疗人群。在这项成本最小化分析中，我们比较了与化疗药物、药物给药和递送、医院和门诊就诊、治疗相关毒性以及中心静脉通路装置相关的总成本。还考虑了患者在时间损失和交通方面的成本。假设患者将接受8个周期的CAPOX或12个周期的mFOLFOX6。
从支付方角度来看，与使用mFOLFOX6相比，使用CAPOX可使每位患者节省5339加元的成本。从社会角度来看，CAPOX也使每位患者节省6080加元。CAPOX节省的最大成本归因于化疗治疗就诊次数减少和中心静脉通路装置使用减少。由于门诊就诊次数减少，CAPOX还减少了患者的时间损失和交通成本。
在结肠癌辅助治疗中用CAPOX替代mFOLFOX6可能从支付方和社会角度带来潜在的成本节省。
