Konference: 2006 31st Congress ESMO - účast ČR
Kategorie: Kolorektální karcinom
Téma: Colorectal cancer
Číslo abstraktu: 356P
Autoři: Lucia Jirásková; MUDr. Tomáš Doležal
Introduction: As adjuvant treatment for colon cancer, X
leads to at least equivalent disease-free survival (DFS) and an
improved safety profile vs. bolus 5-FU/LV [Twelves et al. NEJM
2005;352:2696-704]. X also demonstrates superior relapse-free
survival (65.5% vs. 61.9% at 3 years follow-up; p=0.04) and
improved covariate-adjusted overall survival (p=0.02). We used
X-ACT trial data to evaluate the cost-effectiveness of X from a
Czech perspective. Methods: We used clinical trial data and
published sources in the Czech Republic to determine utilisation
and unit costs for drug administration, hospitalisations, physician
consultation visits, and concomitant medications. Cost for pt time
and travel were also considered (societal perspective). A
health-state transition model was used to estimate incremental cost
impact and the effectiveness in terms of gains in quality-adjusted
life months (QALMs). Costs and effectiveness were discounted at 6%
and 1.5%, respectively. Results: Acquisition costs were
higher for X (3502€) than 5-FU/LV (302€), but this difference was
almost fully offset by significantly higher 5-FU/LV administration
costs (difference of 2092€), cost of adverse events and
hospitalisation costs (difference of 403€); this resulted in
comparable direct costs (difference of 657€ for X vs. 5-FU/LV). Pt
travel and time costs were lower for X vs. 5-FU/LV (cost savings
679€). Adding indirect costs to the direct costs showed that X is
cost saving, requiring 22€ less per patient than 5-FU/LV. In
addition, X is projected to increase QALMs by 9 months compared
with 5-FU/LV. Conclusions: The use of a societal perspective
to measure the time and travel costs associated with the treatments
illustrates the advantage of oral X over bolus 5-FU/LV treatment. X
is also projected to increase life expectancy vs. 5-FU/LV. From the
point of view of incremental cost-utility analysis, X vs. 5-FU/LV
can be considered a dominant (cost-saving and more-effective)
therapy. This pharmacoeconomic analysis supports the replacement of
5-FU/LV with X for the adjuvant treatment of colon cancer in the
Czech Republic.Supported with a research grant from Roche
Datum přednesení příspěvku: 29. 6. 2006