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Cost-effectiveness analysis of capecitabine monotherapy versus capecitabine plus oxaliplatin in elderly patients with advanced gastric cancer

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  • Jingyuan Peng
  • Chongqing Tan
  • Xiaohui Zeng
  • Shikun Liu

Abstract

Background: There is no single standard chemotherapy regimen for elderly patients with advanced gastric cancer (AGC). A phase III trial has confirmed that both capecitabine monotherapy and capecitabine plus oxaliplatin are well tolerated for elderly patients with AGC, but their economic influence in China is unknown. Objective: The purpose of this cost-effectiveness analysis was to estimate the effects of capecitabine monotherapy and capecitabine plus oxaliplatin in elderly patients with AGC on health and economic outcomes in China. Methods: We created a Markov model based on data from a Korean clinical phase III trial to analyze the cost-effectiveness of the treatment of elderly patients in the capecitabine monotherapy (X) group and capecitabine plus oxaliplatin (XELOX) group. The costs were obtained from published reports and the local health system. The utilities were assumed on the basis of the published literature. Costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICER) were estimated. One-way and probabilistic sensitivity analyses (Monte Carlo simulations) were performed. Results: In the cost-effectiveness analysis, X had a lower total cost ($45,731.68) and cost-effectiveness ratio ($65,918.93/QALY). The one-way sensitivity analysis suggested that the most influential parameter was the risk of requiring second-line chemotherapy in XELOX group. The probabilistic sensitivity analysis predicted that the X regimen was cost-effective 100% of the time, given a willingness-to-pay threshold of $26,598. Conclusions: Our findings show that the XELOX regimen is less cost-effective compared to the X regimen for elderly patients with AGC in China from a Chinese healthcare perspective.

Suggested Citation

  • Jingyuan Peng & Chongqing Tan & Xiaohui Zeng & Shikun Liu, 2018. "Cost-effectiveness analysis of capecitabine monotherapy versus capecitabine plus oxaliplatin in elderly patients with advanced gastric cancer," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-12, June.
    • Handle: RePEc:plo:pone00:0199553
    DOI: 10.1371/journal.pone.0199553
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    References listed on IDEAS

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    1. Jens Hougaard & Lars Østerdal & Yi Yu, 2011. "The Chinese healthcare system," Applied Health Economics and Health Policy, Springer, vol. 9(1), pages 1-13, January.
    2. Chongqing Tan & Liubao Peng & Xiaohui Zeng & Jianhe Li & Xiaomin Wan & Gannong Chen & Lidan Yi & Xia Luo & Ziying Zhao, 2013. "Economic Evaluation of First-Line Adjuvant Chemotherapies for Resectable Gastric Cancer Patients in China," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.
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