ISSN:
1569-8041
Keywords:
adjuvant therapy
;
colorectal carcinoma
;
cost-effectiveness analysis
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: Adjuvant chemotherapy (5-fluorouracil, levamisole) is nowstandard practice in the treatment of Dukes' B and C coloretal carcinoma(CRC), and this has increased the financial burden on health care systemsworld-wide. Patients and methods: Between 1993 and 1996, 95 patients in northernNorway were included in a national randomised CRC study, and assigned tosurgery plus adjuvant chemotherapy or surgery alone. In April 1996, 94 of thepatients were evaluable and 82 were still alive. The total treatment costs(hospital stay, surgery, chemotherapy, administrative and travelling costs)were calculated. A questionnaire was mailed to all survivors for assessmentof the quality of their lives (QoL) (EuroQol questionnaire, a simpleQoL-scale, global QoL-measure of the EORTC QLQ-C30), and 62 of them(76%) responded. Results: Adjuvant chemotherapy in Dukes' B and C CRC raised the totaltreatment costs by £3,360. The median QoL was 0.83 (0–1 scale) in botharms. Employing a 5% discount rate and an improved survival of adjuvanttherapy ranging from 5% to 15%, we calculated the cost of onegained quality-adjusted life-year (QALY) to be between £4,800 and £16,800. Conclusion: Using a cut-off point level of £20,000 per QALY, adjuvantchemotherapy in CRC appears to be cost-effective only when the improvement in5-year survival is ≥5%. Adjuvant chemotherapy does not affectshort-term QoL.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008265905933
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