Medical resource use and cost of different first-line treatments for metastatic colorectal cancer in Brazil

Abstract

Background: Metastatic colorectal cancer (mCRC) is one of the most common malignancies worldwide. The availability of new chemotherapeutic agents have modified the treatment of mCRC over the years creating the need to evaluate the financial impact of treatment. The aim of this study was to establish and quantify the financial resources needed during the first-line treatment of mCRC in Brazil.Methods: The authors began by reaching expert consensus using a modified Delphi panel with oncologists working at public and private services in Brazil. Costs were calculated using official databases and the microcosting technique.Results: The panel reached consensus on six regimens used in the first-line treatment of mCRC, as well as the resources involved in the administration of these regimens. All the regimens contain either fluorouracil (5-FU)/leucovorin or capecitabine, combined with either oxaliplatin or irinotecan. The analysis showed that, when compared with intravenous 5-FU/leucovorin, the cost of capecitabine was offset by administration costs.Conclusion: The panel concluded that regimens containing capecitabine, especially capecitabine plus oxaliplatin (XELOX) are less expensive than those containing 5-FU/leucovorin. Given the comparable efficacy and good tolerability of the XELOX regimen, it may be an attractive choice for the first-line treatment of Brazilian patients with mCRC.