Subscribe

Cost-Effectiveness Comparison: FOLFIRI versus FOLFOX

VBCC - February 2011, Volume 2, No 1 - Meeting Highlights
Wayne Kuznar

Anaheim, CA—As first-line treatment of metastatic colorectal cancer, a regimen of leucovorin, 5-fluorouracil, and irinotecan (FOLFIRI) is more costeffective than a regimen of leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX), investigators at Northeastern Uni versity School of Pharmacy, Boston, have suggested. They presented their data at the clinical meeting of the American Society of Health-System Pharmacists.

The slight survival advantage of - fered by the FOLFOX regimen is outweighed by a more than $500,000 increase in total costs, the researchers believe. However, in a 1-way sensitivity analysis, when the cost of the FOLFOX regimen exceeds $2621.60, FOLFIRI is the more cost-effective treatment regimen.

Both FOLFOX and FOLFIRI are first-line chemotherapy regimens for meta static colorectal cancer; “however, each regimen causes a broad array of adverse reactions that influences costs to third-party payers,” according to the investigators.

They performed a modeled costeffectiveness analysis of the 2 chemotherapy regimens, administered every 2 weeks for 10 cycles.

Average wholesale prices were used to calculate the cost of the treatment regimens and the cost associated with side effects.

The costs of clinic visits and hospitalizations were derived from the Centers for Medicare & Medicaid Services fee schedules.

Randomized controlled trials and US Food and Drug Administration monographs were used to determine survival at 18 months and the probabilities of adverse drug reactions.

Patients were assumed to have stage IV metastatic colorectal cancer. The cost analysis did not take into account dose reductions resulting from adverse drug reactions, the use of adjunct chemotherapy, or the costs of second-line chemotherapy regimens. The costs per 10-day cycle were $49,031 for FOLFOX compared with $36,922 for FOLFIRI.

The probability of survival at 18 months was 52% with the FOLFOX regimen and 50% with the FOLFIRI regimen, yielding average cost-effectiveness ratios of $93,606 per patient surviving at 18 months with FOLFOX versus $71,502 with FOLFIRI.

The incremental cost-effectiveness ratio was an additional $646,200 per pa tient surviving with FOLFOX treatment at 18 months versus FOLFIRI treatment.

Related Items
Hypermobility Syndrome Underrecognized, Requires Team-Based Management
Wayne Kuznar
VBCR - October 2016, Vol 5, No 5 published on November 2, 2016 in Rheumatic Diseases
Neuropathies in Rheumatic Diseases Encompass Wide Spectrum of Diagnoses
Wayne Kuznar
VBCR - October 2016, Vol 5, No 5 published on November 2, 2016 in Rheumatic Diseases
Patients with Rheumatoid Arthritis Cite Improvements in Pain, Quality of Life as Treatment Goals
Wayne Kuznar
VBCR - October 2016, Vol 5, No 5 published on November 2, 2016 in Rheumatoid Arthritis
Celecoxib Demonstrates Better Results than Acetaminophen in Patients with Low Back Pain
Wayne Kuznar
VBCR - August 2016, Vol 5, No 4 published on August 25, 2016 in Back Pain
Entrectinib Shows Strong Activity Against a Range of Rare Solid Tumors with Molecular Abnormalities
Wayne Kuznar
VBCC - June 2016, Vol 7, No 5 published on June 17, 2016 in Emerging Therapies
Promising Antitumor Activity of ODM-201 in Metastatic Prostate Cancer
Wayne Kuznar
VBCC - June 2016, Vol 7, No 5 published on June 17, 2016 in Emerging Therapies
Updated NCCN Guideline Calls for EGFR Mutations Testing in All Patients with NSCLC
Wayne Kuznar
VBCC - June 2016, Vol 7, No 5 published on June 17, 2016 in Lung Cancer
Minor Changes in Systemic Therapy Recommendations in NCCN Breast Cancer Guideline
Wayne Kuznar
VBCC - June 2016, Vol 7, No 5 published on June 17, 2016 in Breast Cancer
Nivolumab Monotherapy Prolongs Survival in Patients with Advanced Melanoma
Wayne Kuznar
VBCC - June 2016, Vol 7, No 5 published on June 17, 2016 in Melanoma
NCCN Panel Examines Impact of the Presidential Election on Cancer Care
Wayne Kuznar
VBCC - May 2016, Vol 7, No 4 published on June 3, 2016 in NCCN Conference Highlights
Last modified: May 28, 2014
  • Rheumatology Practice Management
  • Lynx CME
  • American Health & Drug Benefits
  • Value-Based Cancer Care
  • Value-Based Care in Myeloma
  • Value-Based Care in Neurology