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A Cost Comparison of Oral Tegafur Plus Uracil/Folinic Acid and Parenteral Fluorouracil for Colorectal Cancer in Canada

  • Jean A. Maroun

    (Department of Medical Oncology, Ottawa Regional Cancer Centre, Ottawa, Ontario, Canada)

  • Carl Asche

    (Gerontology Research Centre, Simon Fraser University, Burnaby, British Columbia, Canada
    Health Economics and Outcomes Research, Bristol-Myers Squibb Pharmaceutical Group, Montreal, Quebec, Canada)

  • Francoise Romeyer

    (Health Economics and Outcomes Research, Bristol-Myers Squibb Pharmaceutical Group, Montreal, Quebec, Canada)

  • Jayanti Mukherjee

    (Health Economics and Outcomes Research, Bristol-Myers Squibb Pharmaceutical Group, Montreal, Quebec, Canada)

  • Christine Cripps

    (Department of Medical Oncology, Ottawa Regional Cancer Centre, Ottawa, Ontario, Canada)

  • Amit Oza

    (Princess Margaret Hospital, Toronto, Ontario, Canada)

  • Jamie R. Skillings

    (Bristol-Myers Squibb, Pharmaceutical Research Institute, Wallingford, Connecticut, USA)

  • Jacques Letarte

    (Nextractor Inc., Montreal, Canada)

Background: Two randomised, controlled trials (n = 1396) comparing (i) intravenous fluorouracil (FU) plus oral folinic acid (leucovorin) and (ii) oral tegafur plus uracil (UFT) plus folinic acid for the treatment of metastatic colorectal carcinoma found both regimens to have equivalent efficacy in terms of survival, tumour response and time to disease progression. The UFT/folinic acid regimen was associated with a better toxicity profile than FU/folinic acid. Objective: To determine the comparative frequencies and costs of healthcare resources utilised in the treatment of patients with these two regimens from a hospital and government perspective. Design: A cost-minimisation analysis of a subgroup of patients from the trials (n = 154) was conducted. Costs considered included those for hospital admissions, outpatient clinics, laboratories, imaging modalities, other diagnostic procedures, physician resources, other health professionals, other procedures such as surgery and transfusion, and concomitant medications. The cost of study medications was not included in the analysis. The endpoint was a total average cost per patient per treatment and per cycle. Results: Patients on the oral UFT regimen had fewer outpatient clinic visits and used fewer laboratory resources than patients treated with FU. However, those on the oral regimen had more days of hospitalisation than the patients treated with the intravenous regimen. Patients treated with UFT used 21% less concomitant medication; however, in both groups these medications accounted for a similar percentage compared with the total costs of the treatment. Physicians Conclusions: In regard to the two therapeutic approaches, the cost of treatment per patient and per cycle using oral UFT/folinic acid was less than that using intravenous FU/folinic acid.

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Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

Volume (Year): 21 (2003)
Issue (Month): 14 ()
Pages: 1039-1051

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Handle: RePEc:wkh:phecon:v:21:y:2003:i:14:p:1039-1051
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