Economic Evaluation of mFOLFOX6-based First-line Regimens for Unresectable Advanced or Recurrent Colorectal Cancer Using Clinical Decision Analysis
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- Shida Toshihiro
- Division of Pharmacy, Yamagata University Hospital
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- Endo Yuji
- Division of Pharmacy, Yamagata University Hospital
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- Shiraishi Tadashi
- Division of Pharmacy, Yamagata University Hospital
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- Yoshioka Takashi
- Department of Clinical Oncology, Faculty of Medicine, Yamagata University
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- Suzuki Kaoru
- Department of Pharmacy, Yamagata Prefecture Central Hospital
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- Kobayashi Yuka
- Department of Pharmacy, Yamagata Prefecture Central Hospital
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- Ono Yuki
- Department of Pharmacy, Yamagata Prefecture Central Hospital
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- Ito Toshinori
- School of Pharmaceutical Sciences, Ohu University
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- Inoue Tadao
- School of Pharmaceutical Sciences, Ohu University
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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.<br>
Journal
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- YAKUGAKU ZASSHI
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YAKUGAKU ZASSHI 138 (1), 83-90, 2018-01-01
The Pharmaceutical Society of Japan
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Details 詳細情報について
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- CRID
- 1390282681192229248
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- NII Article ID
- 130006300824
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- NII Book ID
- AN00284903
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- ISSN
- 13475231
- 00316903
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- NDL BIB ID
- 028775222
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- PubMed
- 29311468
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- Abstract License Flag
- Disallowed