Cost-utility Analysis of the EOX Drug Regimen versus the DCF Drug Regimen for Patients with Advanced Gastric Cancer

Abstract

Background: Cancer is one of the major causes of mortality and as an effectivefactor in the burden of diseases for the future. Among all cancers, gastric cancer is thefourth most common and the second leading cause of cancer mortality worldwide. Inthis study, we aim to evaluate the cost-utility of two chemotherapy regimens –epirubicin, oxaliplatin, and capecitabine versus docetaxel, cisplatin, and fluorouracilin patients with advanced gastric cancer in a hospital in southern Iran.Method: This cross-sectional study was an economic evaluation of cost-utility typethat included all patients at Amir Hospital (Shiraz, Iran) who had advanced gastric cancerand received either the epirubicin, oxaliplatin, and capecitabine or docetaxel, cisplatin,and fluorouracil chemotherapy regimen. All costs and the quality-adjusted life yearswere calculated, followed by one-way sensitivity analysis to verify the results.Results:A total of 54 patients participated in this study, amongst whom 20 receivedthe epirubicin, oxaliplatin, and capecitabine regimen and 34 received the docetaxel,cisplatin, and fluorouracil regimen. The mean quality of life of patients that receiveddocetaxel, cisplatin, and fluorouracil was 0.747, whereas it was 0.836 for patients thatreceived epirubicin, oxaliplatin, and capecitabine. The docetaxel, cisplatin, andfluorouracil treatment group ($5573) was more expensive than the epirubicin, oxaliplatin,and capecitabine group ($3108). The results obtained from the cost-utility analysisshowed that the epirubicin, oxaliplatin, and capecitabine drug regimen was costeffectivedue to lower cost and higher utility than the docetaxel, cisplatin, andfluorouracil regimen. One-way sensitivity analysis confirmed the accuracy of theseresults.Conclusion: Due to the cost-effectiveness of the epirubicin, oxaliplatin, andcapecitabine drug regimen compared to docetaxel, cisplatin, and fluorouracil, werecommend that oncologists use this regimen to treat gastric cancer patients.

Keywords

• Cost-utility
• EOX
• DCF
• Gastric Cancer