Chemotherapy in gastric cancer: an economic evaluation of the FAM (5-fluorouracil, adriamycin, mitomycin C) versus ELF (etoposide, leucovorin, 5-fluorouracil) regimens

Journal of Chemotherapy
J Norum, V Angelsen

Abstract

The prognosis in gastric cancer has been almost unchanged for the last 20 years. At the time of diagnosis the majority of patients have disseminated disease. The 5-year survival is only about 15%. Several efforts with numerous antineoplastic regimens have been studied. The most widely used regimen has been the FAM (5-fluorouracil, adriamycin, mitomycin C) regimen. Because of the cardiotoxicity and dose intensity of the FAM regimen, a low toxicity regimen, the ELF (etoposide, leucovorin, 5-fluorouracil) regimen, has been introduced. We present the data from the treatment of 26 patients (17 FAM, 9 ELF) with advanced gastric cancer at the University Hospital of Tromsø. The monthly costs of FAM and ELF treatment were calculated to a price of 553 pounds and 2976 pounds (British pounds). The median survival of 5 months (FAM) and 6 months (ELF) is in accordance with other studies. Assuming that the median survival in our study is correct, the cost of one year saved was 123,834 pounds, while the cost of one QALY (quality adjusted life year) employing the ELF compared to the FAM regimen was 104,334 pounds. We conclude that the standard ELF regimen too expensive in the treatment of gastric cancer.

References

Jan 1, 1992·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·R J Epstein
Aug 1, 1990·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R C CoombesA Villar-Grimalt
Dec 1, 1988·Cancer Treatment Reviews·P PreusserH Bunte

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Citations

Jan 15, 2011·Journal of Gastrointestinal Cancer·Joshua A Roth, Josh J Carlson
Jul 10, 2001·Acta Oncologica·G KarlssonUNKNOWN SBU-group. Swedish Council of Technology Assessment in Health Care
Oct 6, 2004·Expert Opinion on Pharmacotherapy·Eva GaliziaStefano Cascinu
Sep 7, 2014·PharmacoEconomics·Alyson L MaharNatalie Coburn

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