Il costo del trattamento del carcinoma del colon retto in stadio avanzato

Summary

Objective The study aim was to: (i) estimate the direct and full costs of five chemotherapy regimens for the treatment of advanced colorectal cancer and (ii) compare the direct costs with the fees reimbursed by the National Health System to the local health providers.

Design An observational, retrospective cost-analysis study. Data were obtained from a sample of 78 patients who underwent the following therapies: 24 were treated with the FU High dose regimen, 22 with the CPT 11 & raltitrexed, 19 with the Mayo Clinic 425, 8 with the Mayo Clinic 375 and 5 with the De Gramont scheme. The observation period was July–November 1999.

Perspective and setting The study was set in an oncology unit of the Clinical Oncology Department of the National Institute for Cancer Research (Genova, Italy) and was conducted from the hospital perspective.

Methods The records of 78 patients who had received, as first-line therapy, one of the five most frequently used regimens in the observed unit between July and September 1999 were analysed.

Results A wide difference among monthly direct cost per patient was highlighted, the average increasing from Lit. 388,500 (Mayo Clinic 375) to Lit. 5,066,300 (CPT 11 & raltitrexed). All alternatives show a positive contribution to overhead with the only exception of the CPT 11 & raltitrexed group.

Conclusions The analysis of the data shows that the Mayo Clinic 375 is the least costly among the chemotherapy regimens considered. Our results, however, do not imply that the cheapest treatment must always be the chosen one. Quantitative financial considerations should actually be integrated by qualitative considerations (such as quality of life aspects) on broadly intended outcomes.