Cost-effectiveness analysis of colon cancer treatments from MOSIAC and No. 16968 trials

Table 1 Parameters used for calculation

	Value
Parameters	FOLFOX4	Data source	XELOX
Overall toxicity after adjuvant chemotherapy
Percentage of major toxicity state Pma	50.9%	43.0%	Andréand others, 2004
Percentage of minor toxicity state Pmi	41.1%	55.0%	Hans-Joachim Schmoll and others, 2007
Percentage of well state Pw	8.0%	2.0%
Percentage of death due to adjuvant chemotherapy Pd	0.5%	0.6%
Percentage of quitting adjuvant chemotherapy Pq	25.3%	22.0%
Probability of well state to well state Pw-w	0.66	0.52	Mehmet US Ayvaci and others, 2012
Probability of well state to minor toxicity state Pw-mi	0.31	0.46
Probability of well state to major toxicity state Pw-ma	0.03	0.02
Probability of minor toxicity state to well state Pmi-w	0.36	0.32
Probability of minor toxicity state to minor toxicity state Pmi-mi	0.32	0.40
Probability of minor toxicity state to major toxicity state Pmi-ma	0.32	0.28
Probability of major toxicity state to well state Pma-w	0.10	0.10
Probability of major toxicity state to minor toxicity state Pma-mi	0.39	0.49
Probability of major toxicity state to major toxicity state Pma-ma	0.30	0.20
Probability of major toxicity state to quitting adjuvant chemotherapy Pma-q	0.20	0.20
Probability of major toxicity state to death due to adjuvant chemotherapy Pma-d	0.01	0.01

Table 2 Utility data for patients in adjuvant chemotherapy

Parameters	Value	Data source
Well state	0.84	Mehmet US Ayvaci and others, 2012
Minor toxicity state	0.73
Major toxicity state	0.59
Quitting adjuvant chemotherapy	0.47
Death due to adjuvant chemotherapy	0.00

Table 3 Patients’ baseline characteristics according to the MOSAIC and No. 16968 trials

	FOLFOX4 (n = 1123)	XELOX (n = 944)
Male, %	56.1	54
Age, yr	61	61
Depth of invasion, %
T1-2	4.5	11
T3	76	74
T4	19	15
TX	0.5	< 1
Histology, %
Differentiated	83.2	81
Poorly differentiated	12.6	15
Unknown	4.2	3

Table 4 Total costs for patients undergoing adjuvant chemotherapy

Parameters	FOLFOX4 ($)	XELOX ($)	Data source
Direct costs/mo	3314.16 ± 713.38	3018.88 ± 520.37	Xie et al[14] and others, 2013
Adverse event costs/mo	145.62 ± 4.6	34.13 ± 2.8
Societal costs/mo	3558.78	3082.5
Cost for well state (Cw1/Cw2)	6872.94 ± 713.38	6101.38 ± 520.37
Cost for minor toxicity state (Cmi1/Cmi2)	Cw1	Cw2
Cost for major toxicity state (Cma1/Cma2)	7018.56 ± 717.98	6135.50 ± 523.17
Cost for quitting adjuvant chemotherapy (Cq1/Cq2)	Cma1	Cma2

Table 5 Cost-effectiveness analysis of the base case

Parameters	FOLFOX4	XELOX
Whole cost	$34416.92	$30466.45
QALY	3.85	3.79
Cost/effect	$8948.28	$8047.30
ICER	$15016.33	-
Threshold (/QALY)	$17815.4	$17815.4

QALY: Quality adjusted life year; ICER: Incremental cost-effectiveness ratio.