Clinical Practice Guidelines - National Health and Medical Research ...

Study Country Study questions Conclusion
Murad et al 117
Monz et al 118
Nicholls et
al 119
Brazil Assessment of costs
of UFT/LV
compared to 5-FU
Germany Comparison of
FU/FA + levamisole
vs FU + levamisole
alone
United
Kingdom
Comparison of 5-
FU/FA + oxaliplatin
vs 5-FU/FA +
irinotecan vs 5-
FU/FA alone
UFT/LV has an economic advantage over
5-FU and is therefore a useful and
economic alternative. Costs for UFT/LV
vs 5-FU (Brazil; Argentina) as adjuvant
therapy were $US9624 vs $US9654
($A15,672 vs $A15,721); $US12,295 vs
$US13,077 ($A20,022 vs $A21,296). For
treatment of metastatic disease, costs
were $US10,178 vs $US10,491
($A16,575 vs $A17,084); $US12,369 vs
$US13,558 ($A20,143 vs $A22,079).
Sensitivity analysis indicates the results
are robust.
Adding FA results in clinical benefits and
costs that may be acceptable to decision
makers in the long term. The 5yr trial
mean overall and disease-free survival
(5% discounted) for FA vs none was
3.72yrs, 3.27yrs vs 3.52yrs vs 2.90yrs.
Survival for beyond the trial was 9.38yrs,
8.11yrs vs 8.13yrs, 7.06yrs. For the trial,
ICERs/LYG and disease free LYG (5%
discounted) were €51,225 and €33,008
($A88,324 and $A56,913). Beyond the
trial, ICERs were €11,020 and €11,176
($A19,001 and $A19,270). Sensitivity
analysis confirmed the results are robust.
Both combinations offer comparable
benefits in terms of effectiveness and
cost-effectiveness over 5-FU/FA alone.
The addition of oxaliplatin is more costeffective
than the addition of irinotecan.
Compared to 5-FU/FA, the ICERs per
progression-free year were ₤26,665 and
₤30,171 ($A70,877 and $A80,102).
Sensitivity analysis indicated ICERs
could range from ₤21,421–31,909
($A56,863–84696) and ₤23,692–36,651
($A62,886–97,284).
Cost effectiveness
277