Cost of Care for Capecitabine vs 5-FU Regimens in Managed Care

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In evaluating a drug’s cost-effectiveness in treating patients with cancer, most managed care plans understand that acquisition costs are only one factor and that it is essential to consider health care costs overall. Using a database of managed care claims, outcomes researchers at Huffman-La Roche Inc in Nutley, New Jersey, examined the total cost of care for patients with metastatic colorectal cancer (N = 1459) who received 5-fluorouracil (5-FU)-based regimens or capecitabine-based chemotherapy regimens from 2004- 2006.

Two-thirds of patients included in this retrospective study underwent treatment for initial tumors; the remaining third received treatment for recurrent cancer.

The study considered treatment costs for patients who received either agent alone or in combination with a drug such as oxaliplatin. Researchers found that total costs for patients treated with capecitabine alone or capecitabine plus oxaliplatin were far lower than costs for patients who underwent treatment with 5-FU monotherapy or in combination with other drugs. They also noted that capecitabine-based therapies resulted in significantly lower ambulatory care costs, total medical costs, and overall costs.

The Huffman-La Roche study pointed out that because the clinical efficacy of the regimens are roughly the same, the 30% to 35% cost premium associated with 5-FU-based therapy suggests that the cost-effectiveness of capecitabine is superior.

Wenhui W, Halpern R, Zeit S. Comparison of health care cost in metastatic colorectal cancer patients treated with capecitabine- or 5-fluorouracil-based regimens in a large managed care plan. Poster presented at: 2008 Educational Conference of the Academy of Managed Care Pharmacy; October 2008; Kansas City, MO.