A Cost-effectiveness Analysis of Capecitabine and Folfox for the Adjuvant Treatement of Stage III Colon Cancer: Which is the More Cost-Effective Option in Ontario?

Background: There are a number of treatment options for colon cancer. These regimens have different toxicity profiles and the age of the patient may affect outcomes of care and cost-effectiveness. An economic evaluation was conducted to explore treatment options for stage III colon cancer. Methods: A Markov model was developed to compare the cost-effectiveness of capecitabine with oxaliplatin combined with fluorouracil/leucovorin (FOLFOX) for the adjuvant treatment of stage III colon cancer. Results: At age 70, FOLFOX was the preferred option, costing $25,314 per quality-adjusted life-year gained. However, the difference in effect between the regimens ranged by 6 months and the model was sensitive to a number of variables. At age 80, capecitabine became the preferred option. Conclusion: FOLFOX is the most cost-effective treatment option in Ontario, but above age 80, capecitabine becomes the favoured option. Uncertainty remains in determining the most cost-effective treatment option for stage III colon cancer.MAS