The Pharmaceutical Journal
Vol 273 No 7325 p708
13 November 2004

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Oral chemotherapy can save time and money

Treating colorectal cancer patients after surgery with the oral chemotherapy agent capecitabine (Xeloda) rather than intravenous 5-fluorouracil/leucovorin (IV 5-FU/LV) saves hospital time equivalent to gaining an additional pharmacist, suggest researchers. They reported data last week at a European Society for Medical Oncology conference held in Vienna.

Pharmacoeconomic data from the X-ACT (Xeloda in adjuvant colon cancer therapy) study, showing that adjuvant capecitabine reduced the risk of colon cancer recurrence by 14 per cent compared with the current standard treatment of IV 5-FU/LV, revealed that it was also associated with reduced overall costs of £1,900 per patient. Patients treated with capecitabine had only one-third of the hospital clinic visits (mean of 8.9 vs 29.5 visits) compared with those given IV 5-FU/LV. They also spent less time in hospital — 113 days per 100 patients compared with 129 days for IV 5-FU/LV — and required less treatment for chemotherapy- related adverse events.

Based on an assessment of direct costs to the NHS, the cost of capecitabine was £1,450 higher than IV 5-FU/LV, but this was more than offset by lower costs associated with fewer hospital clinic visits and admissions (£3,060 lower). The costs of other medicines needed to treat side effects were also reduced (£259 lower with capecitabine).

Chris Twelves, professor of clinical cancer pharmacology and oncology, University of Leeds, said: “For most new drugs we have to find extra funding but, in this case, we can achieve additional clinical benefit at lower overall cost.” He noted that the time saved by hospital clinics in switching to capecitabine was equivalent to gaining an extra member of staff in a typical hospital pharmacy department, as well as freeing medical and nursing time.

The study was funded by Roche, manufacturer of Xeloda.