XELOX (capecitabine plus oxaliplatin) has been shown in study NO16966 to be non-inferior to FOLFOX-4 (5-FU/LV plus oxaliplatin) for first-line treatment of metastatic colorectal cancer (mCRC). We developed a pharmacoeconomic model to compare direct costs of XELOX with FOLFOX-4 from the payer's perspective in Taiwan.
Two complementary cost-minimization analyses were performed to compare the costs of XELOX with FOLFOX-4, both using costs for Taiwan: one looking at the medical resource utilization of these regimens in Taiwan, and the other based on safety/efficacy data from NO16966. Local treatment regimens and drug administration patterns were derived from the results of an expert panel survey conducted among Taiwanese physicians. Unit costs were estimated from the 2009 Taiwan Bureau of National Health Insurance (BNHI) fee schedules. Direct medical costs were associated with the drugs, administration, and adverse event management.
Although XELOX had higher drug costs, these were offset by the higher chemotherapy administration costs for FOLFOX-4, resulting in an overall cost saving with XELOX of NT$35,091 ($1,170; NT$30 = ∼1US$) by 6 months. For the analysis based on NO16966, this difference was NT$71,285 ($2,376).
XELOX for the first-line treatment of mCRC can effectively release the budget pressure for Taiwan's BNHI.
Clinical trial identification
All authors have declared no conflicts of interest.