OBJECTIVETo compare FOLFOX6 and FOLFIRI regimen in the treatment of metastatic colorectal cancer with cost-effective analysis.

METHODSCost-effective analysis was conducted based on the efficacy results of V308 clinical trial of FOLFOX6 and FOLFIRI regimen and the medical system price in Zhongshan hospital.

RESULTSThe minimal cost analysis showed FOLFIRI followed by FOLFOX6 had the cost of RMB 206365.78 Yuan for each patient during the whole treatment period, and RMB 170468.89 Yuan for the FOLFOX6 followed by FOLFIRI regimen. Incremental analysis showed FOLFIRI followed by FOLFOX6 regimen could prolong one month of overall survival with additional cost of RMB 39885.44 Yuan in each patient while compared with the regimen of FOLFOX6 followed by FOLFIRI.

CONCLUSIONSBoth FOLFOX and FOLFIRI regimens are able to prolong the survival time of patients with metastatic colorectal cancer, but cost of such treatments are still quite expensive for Chinese patients. FOLFOX6 regimen suggests better cost-effectiveness than FOLFIRI.

Antineoplastic Combined Chemotherapy Protocols ; economics ; therapeutic use ; Chemotherapy, Adjuvant ; economics ; Colorectal Neoplasms ; drug therapy ; economics ; pathology ; Cost-Benefit Analysis ; economics ; Humans

PURPOSE: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. METHODS: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. RESULTS: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. CONCLUSION: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.
Antineoplastic Combined Chemotherapy Protocols/*economics/therapeutic use ; Carcinoma, Non-Small-Cell Lung/*drug therapy/*economics ; Cisplatin/*economics/therapeutic use ; Cost Allocation ; Cost-Benefit Analysis ; Deoxycytidine/*analogs & derivatives/economics/therapeutic use ; Humans ; Lung Neoplasms/*drug therapy/*economics ; Outpatients

Bevacizumab is increasingly used in recurrent, persistent or metastatic cervical cancer. The early retrospective case reports found that bevacizumab combined with 5-FU (including capecitabine) or paclitaxel was well tolerated and displayed encouraging anti-tumor activity in recurrent or persistent cervical cancer. Phase Ⅱ clinical trials showed that bevacizumab was well tolerated and active in the second- and third-line treatment of patients with recurrent cervical cancer. Large scale phase Ⅱ and phase Ⅲ clinical trials demonstrated that bevacizumab-containing chemotherapy was effective in the first- and second-line treatment of patients with persistent cervical cancer, prolonged survival time and improved remission rate. The article also reviews the research progress on predictive factors of bevacizumab efficacy, showing the use of imaging and biomarkers in predicting the efficacy of bevacizumab treatment. In addition, this article analyzes the cost-effectiveness of bevacizumab, finding that bevacizumab combined with chemotherapy meets the standard of cost-effectiveness.
Antineoplastic Combined Chemotherapy Protocols ; economics ; therapeutic use ; Bevacizumab ; economics ; therapeutic use ; Cost-Benefit Analysis ; Female ; Fluorouracil ; economics ; therapeutic use ; Health Care Costs ; Humans ; Neoplasm Recurrence, Local ; drug therapy ; Paclitaxel ; economics ; therapeutic use ; Remission Induction ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Uterine Cervical Neoplasms ; drug therapy ; economics ; mortality