Cost-effectiveness of adjuvant FOLFOX and 5FU/LV chemotherapy for patients with stage II colon cancer

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dc.citation.epage532en_US
dc.citation.issueNumber4en_US
dc.citation.spage521en_US
dc.citation.volumeNumber33en_US
dc.contributor.authorAyvaci, M.U.S.en_US
dc.contributor.authorShi J.en_US
dc.contributor.authorAlagoz O.en_US
dc.contributor.authorLubner, S.J.en_US
dc.date.accessioned2016-02-08T09:39:11Z
dc.date.available2016-02-08T09:39:11Z
dc.date.issued2013en_US
dc.departmentDepartment of Industrial Engineeringen_US
dc.description.abstractPurpose. We evaluated the cost-effectiveness of adjuvant chemotherapy using 5-fluorouracil, leucovorin (5FU/LV), and oxaliplatin (FOLFOX) compared with 5FU/LV alone and 5FU/LV compared with observation alone for patients who had resected stage II colon cancer. Methods. We developed 2 Markov models to represent the adjuvant chemotherapy and follow-up periods and a single Markov model to represent the observation group. We used calibration to estimate the transition probabilities among different toxicity levels. The base case considered 60-year-old patients who had undergone an uncomplicated hemicolectomy for stage II colon cancer and were medically fit to receive 6 months of adjuvant chemotherapy. We measured health outcomes in quality-adjusted life-years (QALYs) and estimated costs using 2007 US dollars. Results. In the base case, adjuvant chemotherapy of the FOLFOX regimen had an incremental cost-effectiveness ratio (ICER) of $54,359/QALY compared with the 5FU/LV regimen, and the 5FU/LV regimen had an ICER of $14,584/QALY compared with the observation group from the third-party payer perspective. The ICER values were most sensitive to 5-year relapse probability, cost of adjuvant chemotherapy, and the discount rate for the FOLFOX arm, whereas the ICER value of 5FU/LV was most sensitive to the 5-year relapse probability, 5-year survival probability, and the relapse cost. The probabilistic sensitivity analysis indicates that the ICER of 5FU/LV is less than $50,000/QALY with a probability of 99.62%, and the ICER of FOLFOX as compared with 5FU/LV is less than $50,000/QALY and $100,000/QALY with a probability of 44.48% and 97.24%, respectively. Conclusion. Although adjuvant chemotherapy with 5FU/LV is cost-effective at all ages for patients who have undergone an uncomplicated hemicolectomy for stage II colon cancer, FOLFOX is not likely to be cost-effective as compared with 5FU/LV.en_US
dc.description.provenanceMade available in DSpace on 2016-02-08T09:39:11Z (GMT). No. of bitstreams: 1 bilkent-research-paper.pdf: 70227 bytes, checksum: 26e812c6f5156f83f0e77b261a471b5a (MD5) Previous issue date: 2013en
dc.identifier.doi10.1177/0272989X12470755en_US
dc.identifier.issn0272989X
dc.identifier.urihttp://hdl.handle.net/11693/20989
dc.language.isoEnglishen_US
dc.relation.isversionofhttp://dx.doi.org/10.1177/0272989X12470755en_US
dc.source.titleMedical Decision Makingen_US
dc.subjectcalibrationen_US
dc.subjectcolon canceren_US
dc.subjectcost-effectivenessen_US
dc.subjectMarkov modelen_US
dc.subjectstage IIen_US
dc.subjectantineoplastic agenten_US
dc.subjectfluorouracilen_US
dc.subjectfolinic aciden_US
dc.subjectplatinum complexen_US
dc.subjectantineoplastic agenten_US
dc.subjectfluorouracilen_US
dc.subjectfolinic aciden_US
dc.subjectadjuvant chemotherapyen_US
dc.subjectarticleen_US
dc.subjectcalibrationen_US
dc.subjectcolon canceren_US
dc.subjectcolon tumoren_US
dc.subjectcost benefit analysisen_US
dc.subjectcost-effectivenessen_US
dc.subjecthumanen_US
dc.subjectmarkov modelen_US
dc.subjectmultimodality cancer therapyen_US
dc.subjectprobabilityen_US
dc.subjectquality adjusted life yearen_US
dc.subjectstage IIen_US
dc.subjectsurvival rateen_US
dc.subjectColonic Neoplasmsen_US
dc.subjectcalibrationen_US
dc.subjectcolon canceren_US
dc.subjectcost-effectivenessen_US
dc.subjectMarkov modelen_US
dc.subjectstage IIen_US
dc.subjectAntineoplastic Combined Chemotherapy Protocolsen_US
dc.subjectChemotherapy, Adjuvanten_US
dc.subjectColonic Neoplasmsen_US
dc.subjectCombined Modality Therapyen_US
dc.subjectCost-Benefit Analysisen_US
dc.subjectFluorouracilen_US
dc.subjectHumansen_US
dc.subjectLeucovorinen_US
dc.subjectMarkov Chainsen_US
dc.subjectOrganoplatinum Compoundsen_US
dc.subjectProbabilityen_US
dc.subjectQuality-Adjusted Life Yearsen_US
dc.subjectSurvival Rateen_US
dc.subjectAntineoplastic Combined Chemotherapy Protocolsen_US
dc.subjectChemotherapy, Adjuvanten_US
dc.subjectColonic Neoplasmsen_US
dc.subjectCombined Modality Therapyen_US
dc.subjectCost-Benefit Analysisen_US
dc.subjectFluorouracilen_US
dc.subjectHumansen_US
dc.subjectLeucovorinen_US
dc.subjectMarkov Chainsen_US
dc.subjectOrganoplatinum Compoundsen_US
dc.subjectProbabilityen_US
dc.subjectQuality-Adjusted Life Yearsen_US
dc.subjectSurvival Rateen_US
dc.titleCost-effectiveness of adjuvant FOLFOX and 5FU/LV chemotherapy for patients with stage II colon canceren_US
dc.typeArticleen_US

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