A Systematic Review on Economic Evaluation of Oxaliplatin Added Regimens as the Adjuvant Chemotherapy in Stage III Colon CanceP. Lerdkiattikorn, U. Chaikledkaew*, P. Kingkaew and Y. Teerawattananon
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Adjuvant chemotherapy regimens with oxaliplatin added could significantly prolong patient’s survival, but are very costly. Therefore, the economic evaluation studies of oxaliplatin added regimens should be explored. The objective of this study was to review the literatures related to economic evaluation of oxaliplatin added regimen as the adjuvant chemotherapy in stage III colon cancer. Studies comparing both costs and outcomes of oxaliplatin added regimens as the adjuvant chemotherapy in state III colon cancer were included. All related literatures until 2009 were searched through the Pubmed and Cochrane databases. All eligible studies were extracted using data extraction forms. The choices of methods used and economic evaluation results were reviewed. The results showed that thirty studies were reviewed and twenty-six studies were excluded. Four eligible studies related to colon cancer were fully reviewed. All four studies were conducted based on the perspective of healthcare payer which considered only direct medical costs. Outcomes were mostly measured as life year gained, disease–free years and quality-adjusted life years. The cost-utility analysis method using Markov model with a lifetime horizon was performed in all studies. Mostly, data used in the model were retrieved from systematic review, published literature and clinical trials. One-way and probabilistic sensitivity analyses were used to handle parameter uncertainty. Based on the systematic review, FOLFOX4 (oxaliplatin plus 5-fluorouracil and leucovorin, 5FU/LV) or capecitapine was more cost-effective in patients with colon cancer in the US and UK compared with 5FU/LV. There has been no cost-effectiveness study of oxaliplatin added regimens as the adjuvant chemotherapy in patients with colon cancer in Asian countries yet. Such study in Thailand would be very useful information for decision making whether oxaliplatin should be included in the National List of Essential Drugs. Therefore, the cost-effectiveness analysis study should be performed to compare the cost and effectiveness oxaliplatin as adjuvant chemotherapy in stage III colon cancer in Thailand.
Keyword:
Economic evaluation; Cost-effectiveness; Cost-utility; Colonic neoplasms; Adjuvant chemotherapy; Oxaliplatin
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