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Cost Effectiveness of Adding Folinic Acid to Fluorouracil Plus Levamisole as Adjuvant Chemotherapy in Patients with Colon Cancer in Germany

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Author Info
Brigitta U.M. Monz (Department of Health Economics, University of Ulm, Ulm, Germany)
Hans-Helmut Konig (Department of Health Economics, University of Ulm, Ulm, Germany)
Reiner Leidl (Department of Health Economics, University of Ulm, Ulm, Germany)
Ludger Staib (Department of General, Visceral and Transplantation Surgery, University of Ulm, Ulm, Germany)
Karl-Heinrich Link (Department of General, Visceral and Transplantation Surgery, University of Ulm, Ulm, Germany)

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Abstract

Objective: To assess the cost effectiveness of the addition of folinic acid to fluorouracil plus levamisole in patients with colon cancer from the perspective of the German Social Health Insurance. Study Design and Methods: Patients with International Union Against Cancer (Union International Contre Cancer; UICC) II/T4 or UICC III colon cancer enrolled in an open-label randomised clinical trial in Germany (Forschungsgruppe Onkologie Gastrointestinaler Tumoren-1 [FOGT-1]) received either fluorouracil plus levamisole (A, standard) or fluorouracil plus levamisole and folinic acid (B) for 12 months as adjuvant chemotherapy after curative intended surgery. Outcome measures for economic evaluation were disease-free life-years gained (df-LYG) and overall life-years gained (LYG) derived from the respective Kaplan-Meier survival curves. Direct medical costs from the perspective of the German Social Health Insurance were estimated retrospectively (2000 values) and incremental cost-effectiveness ratios (ICERs) were calculated. A Markov model was used to project the trial results beyond 5 years for the patients Results: Adding folinic acid to the fluorouracil/levamisole regimen results in an increase in time to progression and survival in patients with locally advanced colon cancer. Within the trial period of 5 years ICERs (B versus A) were Conclusions: Results of this cost-effectiveness analysis suggest that the addition of folinic acid offers clinical benefits at additional costs which are likely to be acceptable for decision makers in the long term. Cost-effectiveness ratios calculated within the clinical trial period were just above

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Publisher Info
Article provided by Wolters Kluwer Health | Adis in its journal PharmacoEconomics.

Volume (Year): 21 (2003)
Issue (Month): 10 ()
Pages: 709-719
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Handle: RePEc:wkh:phecon:v:21:y:2003:i:10:p:709-719

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Related research
Keywords: Antineoplastics; Colorectal-cancer; Cost-effectiveness; Fluorouracil; Folinic-acid; Levamisole; Pharmacoeconomics;

Find related papers by JEL classification:
C - Mathematical and Quantitative Methods
D - Microeconomics
I - Health, Education, and Welfare
Z - Other Special Topics
I1 - Health, Education, and Welfare - - Health
I19 - Health, Education, and Welfare - - Health - - - Other
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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This page was last updated on 2009-12-17.


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