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

OBJECTIVETo evaluate the standard treatment cost of female breast cancer at different tumor node metastasis (TNM) stages.

METHODSExtracting previous data, calculating by clinical pathway, face-to-face interviewing, and telephone interviewing were adopted to estimate the treatment cost of female breast cancer. The cost was consisted of direct medical expenditure, direct non-medical expenditure, and indirect expenditure.

RESULTSThe direct medical expenditure was extracted from medical record and expense statement of 316 breast cancer cases in Sichuan Cancer Hospital. The direct non-medical expenditure was investigated from 211 patients and their relatives. The indirect expenditure was surveyed from 181 cases who received surgery more than one year ago. The average treatment cost of female breast cancer was ¥160 457 ($23 702), which was adjusted by the proportions of ER, PR, and menses status, and the willingness of patients. The treatment cost (including the outpatient cost for 5 years after surgery, radiotherapy, and chemotherapy) of TNM 0 stage, TNM I stage, TNM II stage, TNM III stage, and TNM IV stage were ¥37 941, ¥122 622, ¥159 594, ¥215 014, and ¥214 229, respectively. The patients with early stage breast cancer payed considerably lower treatment cost than those at advanced stage.

CONCLUSIONEarly detection and treatment of breast cancer may have a real economic significance for reducing the burden of disease.

Adult ; Breast Neoplasms ; economics ; pathology ; therapy ; Chemotherapy, Adjuvant ; economics ; Costs and Cost Analysis ; Female ; Health Care Costs ; Hospitalization ; economics ; Humans ; Mastectomy ; economics ; methods ; Middle Aged ; Neoplasm Staging ; Radiotherapy, Adjuvant ; economics ; Surveys and Questionnaires

In 2005, a program named "Early Detection and Early Treatment of Esophageal and Cardiac Cancer" (EDETEC) was initiated in China. A total of 8279 residents aged 40-69 years old were recruited into the EDETEC program in Linzhou of Henan Province between 2005 and 2008. Howerer, the cost-benefit of the EDETEC program is not very clear yet. We conducted herein a cost-benefit analysis of screening for esophageal and cardiac cancer. The assessed costs of the EDETEC program included screening costs for each subject, as well as direct and indirect treatment costs for esophageal and cardiac severe dysplasia and cancer detected by screening. The assessed benefits of this program included the saved treatment costs, both direct and indirect, on esophageal and cardiac cancer, as well as the value of prolonged life due to screening, as determined by the human capital approach. The results showed the screening cost of finding esophageal and cardiac severe dysplasia or cancer ranged from RMB 2707 to RMB 4512, and the total cost on screening and treatment was RMB 13 115-14 920. The cost benefit was RMB 58 944-155 110 (the saved treatment cost, RMB 17 730, plus the value of prolonged life, RMB 41 214-137 380). The ratio of benefit-to-cost (BCR) was 3.95-11.83. Our results suggest that EDETEC has a high benefit-to-cost ratio in China and could be instituted into high risk areas of China.
Adult ; Aged ; Cardia ; pathology ; China ; Cost-Benefit Analysis ; Early Detection of Cancer ; economics ; Esophageal Neoplasms ; diagnosis ; economics ; therapy ; Health Care Costs ; Humans ; Mass Screening ; economics ; Middle Aged ; Stomach Neoplasms ; diagnosis ; economics ; therapy

OBJECTIVETo assess the clinical efficacy of global traditional Chinese medicine (TCM) therapy in treating senile advanced non-small cell lung cancer (NSCLC), with the aim of seeking a standardized, rational and economical way to treat advanced NSCLC in old patients.

METHODSA retrospective analysis and comparison was carried out in 86 patients with senile advanced NSCLC, 44 treated by global TCM (TCM group) and 42 by chemotherapy (control group) through dynamical observation on related indexes including tumor size, quality of life and the survival time, as well as on the fee for medical service at various time points in the course of the treatment.

RESULTSThe changes of tumor size, score of clinical main symptoms and behavior condition (by ZPS scoring), as well as survival rates in the two groups at corresponding time points, were not different significantly (P>0.05). The mean survival time in the TCM group was 13.20+/-1.52 months and that in the chemotherapy group was 13.45+/-1.94 months, showing insignificant difference between them. However, the median survival time in the TCM group (12 months) was actually longer than that in the chemotherapy group (9 months, P<0.05). The mean daily expense and the mean expense (RMB yuan) for each patient in the TCM group were significantly lower than that in the control group, which was 180.73+/-93.21 vs 825.84+/-329.63 for the mean daily expense and 34077.21+/-14638.04 vs 58516.59+/-45429.76 for the mean expense for each patient (both P<0.01).

CONCLUSIONTreatment of senile advanced NSCLC with TCM alone has its apparent superiority in stabilizing tumor focus, improving clinical symptoms, elevating quality of life and prolonging the survival time. TCM is also less expensive, making it a good alternative therapeutic approach for this specific group of people.

Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; economics ; mortality ; pathology ; therapy ; Disease Progression ; Female ; Humans ; Lung Neoplasms ; economics ; mortality ; pathology ; therapy ; Male ; Medicine, Chinese Traditional ; economics ; methods ; Middle Aged ; Retrospective Studies ; Survival Analysis ; Time Factors ; Treatment Outcome

The number of cancer survivors is increasing dramatically. Many cancer survivors face lifetime risks associated with their cancer therapy, with a significant proportion at risk for serious morbidity and premature mortality. Concerns regarding the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public and private sector. This article summarizes economic burden of cancer survivors, main post-treatment health problems including secondary primary cancer and comorbidities, health behaviors such as smoking, exercise and physical activity, nutrition, and psychosocial problems. Faced with various health and psychosocial problems specific to this population, several healthcare and policy models are being suggested to address these issues, including 'shared care model' and 'integrative supportive care service delivery system for cancer survivors'. More effort is needed to make the cancer survivorship agenda a reality, attended by a wide variety of stakeholders including researchers, patients, providers, and policy makers.
Delivery of Health Care ; Health Behavior ; Health Services Needs and Demand ; Humans ; Mental Health ; Neoplasms/economics/pathology/*therapy ; Neoplasms, Second Primary/epidemiology/mortality/pathology ; *Public Health ; Republic of Korea