ADJUVANT CHEMOTHERAPY IN PATIENTS WITH RESECTABLE STAGE-III COLON-CANCER - LIFETIME COST-EFFECTIVENESS AND COST-UTILITY ANALYSIS

Our study was aimed at determining the values of cost, survival, and q uality-adjusted survival in patients with resectable colon cancer rece iving adjuvant chemotherapy with levamisole and fluorouracil. To quant ify quality-adjusted lifetime survival, we employed a combined method utilizing both the Q-TWIST approach and the Gompertz technique. This c ombined method was used to assess the incremental ratios of cost-effec tiveness and costutility for chemotherapy with levamisole + fluorourac il as compared with no adjuvant treatment. The clinical data included in our study were obtained from a long-term controlled trial involving 304 patients given adjuvant treatment and 315 controls. Cost data (in cluding 3% discount rate per annum) were derived from drug acquisition costs and costs related to fluorouracil administration. Our results s howed that in patients with resectable Stage III colon cancer, adjuvan t chemotherapy with fluorouracil + levamisole improved life expectancy by 284 discounted years for every 100 patients and quality-adjusted s urvival by 269 discounted QALYs for every 100 patients. After estimati ng a lifetime incremental cost of $403,730 for every 100 patients, the incremental cost-effectiveness ratio was calculated as $1,422 per lif e year gained (95% CI: $901 to $2,639). The cost-utility ratio was $1, 501 per QALY gained. We conclude that the adjuvant chemotherapy with f luorouracil + levamisole in patients with stage III colon cancer has a n extremely favorable pharmacoeconomic profile.