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Cost-effectiveness analysis of capecitabine monotherapy versus capecitabine plus oxaliplatin in elderly patients with advanced gastric cancer
Cost-effectiveness analysis of capecitabine monotherapy versus capecitabine plus oxaliplatin in elderly patients with advanced gastric cancer
- Source :
- PLoS ONE, Vol 13, Iss 6, p e0199553 (2018), PLoS ONE
- Publication Year :
- 2018
- Publisher :
- Public Library of Science (PLoS), 2018.
-
Abstract
- Background There is no single standard chemotherapy regimen for elderly patients with advanced gastric cancer (AGC). A phase III trial has confirmed that both capecitabine monotherapy and capecitabine plus oxaliplatin are well tolerated for elderly patients with AGC, but their economic influence in China is unknown. Objective The purpose of this cost-effectiveness analysis was to estimate the effects of capecitabine monotherapy and capecitabine plus oxaliplatin in elderly patients with AGC on health and economic outcomes in China. Methods We created a Markov model based on data from a Korean clinical phase III trial to analyze the cost-effectiveness of the treatment of elderly patients in the capecitabine monotherapy (X) group and capecitabine plus oxaliplatin (XELOX) group. The costs were obtained from published reports and the local health system. The utilities were assumed on the basis of the published literature. Costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICER) were estimated. One-way and probabilistic sensitivity analyses (Monte Carlo simulations) were performed. Results In the cost-effectiveness analysis, X had a lower total cost ($45,731.68) and cost-effectiveness ratio ($65,918.93/QALY). The one-way sensitivity analysis suggested that the most influential parameter was the risk of requiring second-line chemotherapy in XELOX group. The probabilistic sensitivity analysis predicted that the X regimen was cost-effective 100% of the time, given a willingness-to-pay threshold of $26,598. Conclusions Our findings show that the XELOX regimen is less cost-effective compared to the X regimen for elderly patients with AGC in China from a Chinese healthcare perspective.
- Subjects :
- Oncology
Economics
Cost-Benefit Analysis
Cancer Treatment
Social Sciences
lcsh:Medicine
law.invention
Geographical Locations
Elderly
0302 clinical medicine
Randomized controlled trial
law
Medicine and Health Sciences
Ethnicities
030212 general & internal medicine
lcsh:Science
Aged, 80 and over
Multidisciplinary
Pharmaceutics
Cost-effectiveness analysis
Chemotherapy regimen
humanities
Oxaliplatin
Treatment Outcome
030220 oncology & carcinogenesis
Drug Therapy, Combination
Research Article
medicine.drug
China
medicine.medical_specialty
Asia
XELOX Regimen
Cost-Effectiveness Analysis
Antineoplastic Agents
Capecitabine
03 medical and health sciences
Drug Therapy
Stomach Neoplasms
Internal medicine
Republic of Korea
Gastrointestinal Tumors
medicine
Humans
Chemotherapy
Computer Simulation
Aged
business.industry
lcsh:R
Cancers and Neoplasms
Economic Analysis
Clinical trial
Gastric Cancer
Regimen
Geriatrics
Age Groups
People and Places
Population Groupings
lcsh:Q
business
Chinese People
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....e7daa7d90a3b9929771a24895d285841
- Full Text :
- https://doi.org/10.1371/journal.pone.0199553