Mgh. Groener et al., An economic evaluation of Tomudex (raltitrexed) and 5-fluorouracil plus leucovorin in advanced colorectal cancer, ANTI-CANC D, 10(3), 1999, pp. 283-288
Our objective was to establish the balance between costs and effects of tre
atment with Tomudex (raltitrexed) as an alternative to treatment with B-flu
orouracil (5-FU) plus leucovorin (LV) in patients with advanced colorectal
cancer. Data were used from an international, open label randomized clinica
l trial. Costs were calculated by multiplying resource utilization data wit
h Dutch estimates of unit costs. Effects have been expressed in terms of 6
months and 1 year survival, and in terms of the number of patients without
severe adverse events including WHO grade 3 and 4 leucopenia, mucositis, an
emia and severe asthenia. Cost effectiveness is expressed in terms of costs
per additional day of survival and costs per additional patient without an
y severe adverse event. The clinical results did not show significant survi
val differences implying great uncertainty about the cost-effectiveness of
raltitrexed in terms of additional costs per additional life-year gained. H
owever, 80% of the initially higher cost of raltitrexed ($3132 per patient)
is compensated by savings due to a more convenient administration scheme l
eading to a net cost of $626 per patient treated. Weighed against the decre
ase in adverse events, a cost-effectiveness ratio results of $3936 per addi
tional patient free of any severe adverse event, More favorable estimates r
esult when the convenience of the administration scheme is valued in positi
ve monetary terms, [(C) 1999 Lippincott Williams & Wilkins.]