Treatment cost of metastatic colon cancer in Turkey
DOI:
https://doi.org/10.7175/fe.v14i1.472Keywords:
Oncology, Colon cancer, Cost-effectivenessAbstract
OBJECTIVES: Colon cancer is the third most common in the top cancer incidence list in Europe. In Europe 212,000 patients die every year due to colon cancer. In Turkey 120,000-130,000 new cancer patients are diagnosed every year, 7.1% of whom are diagnosed to have developed colon cancer. Metastases will occur in up to 50% of the patients who are newly diagnosed. Survival appears to be further prolonged to more than 20 months with new pharmaceuticals; however, these new pharmaceuticals increase the total cost of care. The aim of this study is to estimate the cost implications of new colon cancer treatment options for Turkey.METHODS: Gazi University Hospital treatment protocols for colon cancer treatment were used. Cost of FUFA (5 FU/LV), FOLFIRI, FOLFOX, bevacizumab/FUFA, bevacizumab/FOLFIRI, bevacizumab/FOLFOX, irinotecan and irinotecan/cetixumab protocols were calculated. The cost of combination of protocols were calculated depending on a Markov analysis. The exchange rate was US$ 1 for TL 1.5.
RESULTS: Depending on the life expectancy the lowest total cost was established by FUVA (US$ 5,359). It was followed by FOLFIRI then FOLFOX and FOLFOX, US$ 14,144 and US$ 16,553, respectively. The lowest cost for each week of life expectancy was established by FUVA with US$ 98.
CONCLUSIONS: Only FUFA, FOLFIRI followed by FOLFIX, FOLFIRI/bevacizumab then FOLFOX then cetuximab, FOLFOX/bevacizumab then irinotecan then cetuximab/irinotecan and FOLFIRI/bevacizumab then FOLFOX then cetuximab/irinotecan were under the cost effectiveness curve. In addition no treatments ICER was under the WHO`s threshold for Turkey, except FOLFIRI then FOLFOX compared with FUVA.
References
Agency for Health Care Policy and Research. Colorectal cancer screening: technical review. Rockville : Agency for Health Care Policy and Research, 1998
WHO. Global cancer rates could increase by 50% to 15 million by 2020. Available via URL: http://www.who.int/mediacentre/releases/2003/pr27/en/print.html
Song X, Barber ZZB, Gregory C, et al. Cost of illness in patients with metastatic colorectal cancer. Journal of Medical Economics 2011; 4: 1-9
The American Cancer Society (ACS). Cancer facts & figures, 2002. Available via URL: http://www.uhmsi.com/docs/CancerFacts&Figures2002.pdf
Ministry of Health, Labour and Welfare of Japan. Population survey report [in Japanese]. Tokyo: Ministry of Health, Labour and Welfare, 2006
Omura K. Advances in chemotherapy against advanced or metastatic colorectal cancer. Digestion 2008; 77(suppl 1): 13-22
Türkiye Kanser İstatistikleri (Cancer Statistics of Turkey). Center for early diagnosis, screening and training for cancer
Benson A. Epidemiology, disease progression and economic burden of colorectal cancer. J Manag Care Pharm 2007; 1: S5-18
Fight colorectal: cost of cancer care expected to skyrocket in next decade. Available via URL: http://fightcolorectalcancer.org/policy_news/2011/01/cost_of_cancer_care_expected_to_skyrocket_in_next_decade
Starling N, Tilden D, White J, et al. Cost-effectiveness analysis of cetuximab/irinotecan vs active/best supportive care for the treatment of metastatic colorectal cancer patients who have failed previous chemotherapy treatment. British Journal of Cancer 2007; 96: 206-12; http://dx.doi.org/10.1038/sj.bjc.6603561
[No authors listed]. Meta-analysis of randomized trials testing the biochemical modulation of fluorouracil by methotrexate in metastatic colorectal cancer. Advanced Colorectal Cancer Meta-Analysis Project. J Clin Oncol 1994; 12: 960-9
[No authors listed]. Efficacy of intravenous continuous infusion of fluorouracil compared with bolus administration in advanced colorectal cancer. Meta-analysis Group In Cancer. J Clin Oncol 1998; 16: 301-8
Cunningham D, Pyrhonen S, James RD, et al. Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. Lancet 1998; 352: 1413-8; http://dx.doi.org/10.1016/S0140-6736(98)02309-5
Rothenberg ML, Oza AM, Bigelow RH, et al. Superiority of oxaliplatin and fluorouracil-leucovorin compared with either therapy alone in patients with progressive colorectal cancer after irinotecan and fluorouracil-leucovorin: interim results of a phase III trial. J Clin Oncol 2003; 21: 2059-69
Tournigand C, Andre T, Achille E, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 2004; 22: 229-37; http://dx.doi.org/10.1200/JCO.2004.05.113
Wong Y, Meropol NJ, Speier W, et al. Cost Implications of New Treatments for Advanced Colorectal Cancer. Cancer 2009; 115: 2081-91
Kockaya G, Wertheimer A. What are the top most costly diseases for USA? The alignment of burden of illness with prevention and screening expenditures. Health 2010; 2: 1174-8; http://dx.doi.org/10.4236/health.2010.210172
Uslu R, Kapkac M, Karaca B, et al. Screening for metastasis in primary breast cancer patients having four or more axillary lymph node involvement: is it really necessary? J BUON 2010; 15: 561-7
Cakir Edis E, Karlikaya C. The cost of lung cancer in Turkey. Tuberk Toraks 2007; 55: 51-8
Republic of Turkey. Social Security Institution. Available via URL: http://www.sgk.gov.tr
WHO. CHOosing Interventions that are Cost Effective (WHO-CHOICE). Available via URL: http://www.who.int/choice/costs/CER_thresholds/en/index.html
Meropol NJ, Schulman KA. Cost of cancer care: issues and implications. J Clin Oncol 2007; 25: 180-6
National Service Center for Environmental Publications. Cost of illness. Enviromental Protection Agency, 2007. Available via URL: http://www.epa.gov/opptintr/coi/pubs/II_7.pdf
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