Cost of treating advanced colorectal cancer: A retrospective comparison of treatment regimens

Introduction of new agents on to hospital drug formularies requires the demonstration of efficacy, safety and cost advantages. An audit of the total monthly costs of 'Tomudex'(TM)* (raltitrexed; administered every 3 weeks), a drug recently introduced for the treatment of advanced colorectal cancer, and three 5-fluorouracil-based regimens [5-day daily bolus (Mayo); continuous ambulatory pump; 48-h continuous infusion (De Gramont)] was undertaken. Patient-specific costs associated with fluids, concomitant medication and consumables were largely negligible, but chemotherapy was the main cost driver in the raltitrexed and De Gramont groups. Fixed inpatient costs were highest for the patients receiving the De Gramont regimen which required more inpatient stays each month. Total costs (patient-specific plus fixed costs) were lowest in patients on the Mayo regimen (mean pound 954.03; median pound 659.68), followed by patients in the ambulatory pump (mean pound 1207.61; median pound 749.19), raltitrexed [mean pound 1256.93; median pound 1087.14 (mean pound 1117.85; median pound 959.34 when costs of protocol-driven visits were excluded)], and De Gramont groups (mean pound 2028.52; median pound 1775.66). The pattern of costs varied considerably between regimens, such that high drug costs, for example those associated with raltitrexed therapy, were partially offset by reductions in hospital visits and stays. Copyright (C) 1996 Elsevier Science Ltd