Economic assessment of capecitabine/cisplatin versus 5-FU/cisplatin regimens in adjuvant treatment of advanced gastric cancer in Spain

Abstract

15549 Background: A randomized phase III trial of Capecitabine/Cisplatin (XP) versus continuous infusion of 5-FU/Cisplatin (FP) as first-line therapy in patients with advanced gastric cancer (AGC) met its primary endpoint of non-inferior progression-free survival (PFS). There was a trend toward superior efficacy with XP in terms of both PFS (median 5.6 months for XP versus 5.0 for FP) and response rates. An economic assessment was conducted in Spain to compare the costs of the two therapies taking into account unit costs and medical resource consumption for year 2007. Methods: Direct medical costs during the study period were estimated from the perspective of the Spanish National healthcare system. The costs of the two alternative therapies were estimated based on the trial results on actual dose and the number of administrations, and unit costs in different hospitals in Spain. The adverse event (AE) profiles were used to estimate the costs of treating AEs. An expert panel estimated typical treatment patterns and costs of treating major AEs. Indirect costs for time and travel for study drug administration were also estimated. Results: Annual pharmacologic cost in the XP arm were estimated to be €1,333 greater than in the XP arm, but drug administration costs and AE costs were lower in the XP arm (€2,575 and €27, respectively). Overall, direct an indirect medical cost were estimated at €2,688 in the XP arm and at €4,014 in the FP arm. According to budget impact results, 1.58 patients are likely to be treated with XP for each patient treated with FP. Conclusions: In Spain, oral capecitabine benefits AGC patients by reducing the number and time spent in infusion visits, and would produce significant direct medical cost savings. Given the trend to superior efficacy, the projected direct and indirect cost savings, and the convenience of oral treatment, XP treatment would be considered less costly than FP treatment for AGC from both a healthcare system and a societal perspective. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Roche Pharma