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[Economic Evaluation of mFOLFOX6-based First-line Regimens for Unresectable Advanced or Recurrent Colorectal Cancer Using Clinical Decision Analysis].
- Source :
-
Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan [Yakugaku Zasshi] 2018; Vol. 138 (1), pp. 83-90. - Publication Year :
- 2018
-
Abstract
- We evaluated four representative chemotherapy regimens for unresectable advanced or recurrent KRAS-wild type colorectal cancer: mFOLFOX6, mFOLFOX6+bevacizumab (Bmab), cetuximab (Cmab), or panitumumab (Pmab). We employed a decision analysis method in combination with clinical and economic evidence. The health outcomes of the regimens were analyzed on the basis of overall and progression-free survival. The data were drawn from the literature on randomized controlled clinical trials of the above-mentioned drugs. The total costs of the regimens were calculated on the basis of direct costs obtained from the medical records of patients diagnosed with unresectable advanced or recurrent colorectal cancer at Yamagata University Hospital and Yamagata Prefecture Central Hospital. Cost effectiveness was analyzed using a Markov chain Monte Carlo (MCMC) method. The study was designed from the viewpoint of public medical care. The MCMC analysis revealed that expected life months and expected cost were 20 months/3,527,119 yen for mFOLFOX6, 27 months/8,270,625 yen for mFOLFOX6+Bmab, 29 months/13,174,6297 yen for mFOLFOX6+Cmab, and 6 months/12,613,445 yen for mFOLFOX6+Pmab. Incremental costs per effectiveness ratios per life month against mFOLFOX6 were 637,592 yen for mFOLFOX6+Bmab, 1,075,162 yen for mFOLFOX6+Cmab, and 587,455 yen for mFOLFOX6+Pmab. Compared to the conventional mFOLFOX6 regimen, molecular-targeted drug regimens provide better health outcomes, but the cost increases accordingly. mFOLFOX 6+Pmab is the most cost-effective regimen among those surveyed in this study.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal administration & dosage
Antibodies, Monoclonal economics
Bevacizumab administration & dosage
Bevacizumab economics
Cetuximab administration & dosage
Cetuximab economics
Colorectal Neoplasms mortality
Colorectal Neoplasms pathology
Female
Fluorouracil economics
Humans
Leucovorin economics
Male
Markov Chains
Middle Aged
Neoplasm Staging
Organoplatinum Compounds economics
Panitumumab
Survival Rate
Treatment Outcome
Antineoplastic Combined Chemotherapy Protocols economics
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Colorectal Neoplasms drug therapy
Colorectal Neoplasms economics
Cost-Benefit Analysis
Decision Support Techniques
Neoplasm Recurrence, Local diet therapy
Subjects
Details
- Language :
- Japanese
- ISSN :
- 1347-5231
- Volume :
- 138
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan
- Publication Type :
- Academic Journal
- Accession number :
- 29311468
- Full Text :
- https://doi.org/10.1248/yakushi.17-00159