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Shibahara, Hidetoshi; Shiroiwa, Takeru; Ishiguro, Megumi; Nakamura, Masato; Hasegawa, Junichi; Yamaguchi, Shigeki; Masuda, Yuriko; Sakamoto, Junichi; Tomita, Naohiro; Fukuda, Takashi

Cost-effectiveness of 12 months of capecitabine as adjuvant chemotherapy for stage III colon cancer: preplanned cost-effectiveness analysis of the JFMC37-0801 study

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  • Medientyp: E-Artikel
  • Titel: Cost-effectiveness of 12 months of capecitabine as adjuvant chemotherapy for stage III colon cancer: preplanned cost-effectiveness analysis of the JFMC37-0801 study
  • Beteiligte: Shibahara, Hidetoshi; Shiroiwa, Takeru; Ishiguro, Megumi; Nakamura, Masato; Hasegawa, Junichi; Yamaguchi, Shigeki; Masuda, Yuriko; Sakamoto, Junichi; Tomita, Naohiro; Fukuda, Takashi
  • Erschienen: Springer Science and Business Media LLC, 2022
  • Erschienen in: The European Journal of Health Economics
  • Sprache: Englisch
  • DOI: 10.1007/s10198-021-01418-6
  • ISSN: 1618-7598; 1618-7601
  • Schlagwörter: Health Policy ; Economics, Econometrics and Finance (miscellaneous)
  • Entstehung:
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  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Objectives</jats:title> <jats:p>We evaluated the cost-effectiveness of a 12-month regimen of oral capecitabine versus a standard 6-month regimen as postoperative adjuvant chemotherapy for stage III colon cancer.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>We utilized patient-level data from a multi-institutional randomized controlled trial (JFMC37-0801) that investigated prolonged oral fluoropyrimidine monotherapy. The analysis considered three health states: stable disease, post-metastasis, and death. A parametric statistical model with a cure model was used to estimate the survival curve. The analysis was conducted from the Japanese public healthcare payer’s perspective, considering only direct medical costs. A lifetime horizon was used, with a discount rate of 2% for both cost and health outcomes. Health outcomes were evaluated in terms of quality-adjusted life-years (QALYs).</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The estimated cure rates for colon cancer were 0.726 [95% confidence interval (CI) 0.676–0.776] and 0.694 (95% CI 0.655–0.733) with the 12- and 6-month regimens, respectively; and the estimated 5-year relapse-free survival rates were 74.4% and 69.8%, respectively. The estimated lifetime cost for 12 months of capecitabine was JPY 3.365 million (USD 31,159), compared with JPY 3.376 million (USD 31,262) for 6 months. The estimated QALY were 12.48 and 11.77 for the 12- and 6-month regimens, respectively. Thus, the 12-month capecitabine regimen was dominant. Using a willingness-to-pay threshold of JPY 5 million per QALY, we determined a 97.4% probability that the 12-month capecitabine regimen is more cost-effective than the 6-month regimen.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Twelve months of capecitabine is the favorable option for postoperative adjuvant chemotherapy for stage III colon cancer from the perspective of cost-effectiveness.</jats:p> </jats:sec>