ABSTRACT
BACKGROUND: Evidence suggests that CAPOX (capecitabine and oxaliplatin) has efficacy similar to 5-fluorouracil and oxaliplatin (mFOLFOX6) in the adjuvant treatment of colon cancer. CAPOX is partly administered orally and associated with a 3-week rather than a 2-week treatment cycle. A population-based cost-minimization analysis was conducted from the health care payer and societal perspectives to evaluate the potential cost savings of replacing mFOLFOX6 with CAPOX. METHODS: We applied treatment and toxicity data from phase III trials of CAPOX and FOLFOX-based regimens to the adjuvant colon cancer population in British Columbia, Canada. In this cost-minimization analysis we compared the total costs associated with chemotherapy medications, drug administration and delivery, hospital and clinic visits, treatment-related toxicities, and central venous access devices. Costs to patients in terms of lost time and travel were also considered. It was assumed that patients would receive either 8 cycles of CAPOX or 12 cycles of mFOLFOX6. RESULTS: From the payer perspective, the use of CAPOX resulted in cost savings of $5339 CAD per patient compared with the use of mFOLFOX6. From a societal perspective, CAPOX was also associated with savings of $6080 CAD per patient. The greatest cost savings with CAPOX were attributed to fewer visits for chemotherapy treatment and decreased central venous access device usage. CAPOX was also associated with reduced loss of time and decreased travel for patients because of the requirement of fewer clinic visits. CONCLUSIONS: Replacement of mFOLFOX6 with CAPOX in the adjuvant treatment of colon cancer might be associated with potential cost savings from the payer and societal perspectives.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/economics , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant/economics , Chemotherapy, Adjuvant/methods , Colonic Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/adverse effects , British Columbia , Capecitabine/administration & dosage , Capecitabine/adverse effects , Capecitabine/economics , Clinical Trials, Phase III as Topic , Costs and Cost Analysis , Fluorouracil/adverse effects , Fluorouracil/economics , Humans , Leucovorin/adverse effects , Leucovorin/economics , Organoplatinum Compounds/administration & dosage , Organoplatinum Compounds/adverse effects , Organoplatinum Compounds/economics , OxaliplatinABSTRACT
Version 3 of the Atmospheric Trace Molecule Spectroscopy (ATMOS) experiment data set for some 30 trace and minor gas profiles is available. From the IR solar-absorption spectra measured during four Space Shuttle missions (in 1985, 1992, 1993, and 1994), profiles from more than 350 occultations were retrieved from the upper troposphere to the lower mesosphere. Previous results were unreliable for tropospheric retrievals, but with a new global-fitting algorithm profiles are reliably returned down to altitudes as low as 6.5 km (clouds permitting) and include notably improved retrievals of H2O, CO, and other species. Results for stratospheric water are more consistent across the ATMOS spectral filters and do not indicate a net consumption of H2 in the upper stratosphere. A new sulfuric-acid aerosol product is described. An overview of ATMOS Version 3 processing is presented with a discussion of estimated uncertainties. Differences between these Version 3 and previously reported Version 2 ATMOS results are discussed. Retrievals are available at http://atmos.jpl.nasa.gov/atmos.