From a societal perspective, selleck chemicals Dasatinib capecitabine treatment was associated with cost savings of ��1184 and ��134 for time and travel costs, respectively, yielding cost savings per patient of approximately ��4971. Table 3 Results of the cost-effectiveness analysis: costs during treatment Considering post-treatment costs as well as costs during treatment, the projected direct cost saving for the NHS from a lifetime perspective is projected to be ��3608 per patient. From a societal perspective, the lifetime cost savings are even greater: ��4925 per patient. Clinical effectiveness In terms of overall survival, the Kaplan�CMeier projection was 81.3% of patients receiving capecitabine surviving at 36 months compared with 77.6% of patients receiving i.v. 5-FU/LV, an absolute difference of 3.7%.

In the fitted model, the projected survival gains with capecitabine by 36 and 48 months were 0.5 QALMs and 0.8 QALMs, respectively (Figure 3). When the fitted model is used to extrapolate to longer horizons, for example, 5 years, 10 years or lifetime, the projected gain in QALMs continues to increase with capecitabine, even after taking into account adjustments for quality of life and discounting. Over a lifetime, for example, the QALM advantage for capecitabine widens to 9 months. Figure 3 Net gain with capecitabine compared with 5-FU/LV in QALMs by model horizon. Sensitivity analyses Table 4 shows the impact of varying model estimates on short-term costs and QALMs. Varying drug acquisition costs for study drugs and medications for management of AEs had only a marginal effect on short-term cost savings: the total cost savings were ��14 637 and ��14 590 at the 5th and 95th percentiles, respectively.

A 20% variation in cost per drug administration visit, however, yielded an almost two-fold variation (��4577�C��2707). Overall, the sensitivity analyses confirmed substantial cost savings for oral capecitabine vs 5-FU/LV. These analyses also confirmed that the substantial QALM advantage for capecitabine vs 5-FU/LV would be maintained even in the face of variation of health state utilities and the discount rate for costs and benefits. Table 4 Results of one-way sensitivity analyses The results of the multi-way sensitivity analysis for post-treatment costs are shown in Table 5. These results demonstrate that the long-term cost advantages of capecitabine are lowest when the costs of relapse and maintenance are low.

It is clear that even under rigorous Cilengitide multi-way sensitivity testing, capecitabine remains a robust, cost-saving treatment option compared with 5-FU/LV. Table 5 Results of multi-way sensitivity analysis for post-treatment costs DISCUSSION From a UK NHS perspective, this pharmacoeconomic analysis projects that the use of capecitabine for adjuvant treatment of colon cancer would not only save direct medical costs, but also improve health outcomes compared with 5-FU/LV.