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

@entity1 @entity694 @entity204 @entity137
AIM: To compare XELOX and FOLFOX4 as @entity694 adjuvant chemotherapy based on MOSAIC and No. 16968 trails from Chinese cost-effectiveness perspective. METHODS: A decision-analytic Markov model was developed to compare the FOLFOX4 and XELOX regimens based MOSAIC and No. 16968 trial. Five states were included in our Markov model: well (state 1), minor @entity137 (state 2), major @entity137 (state 3), quitting adjuvant chemotherapy (state 4), and @entity204 due to adjuvant chemotherapy (state 5). Transitions among the 5 states were assumed to be Markovian. Costs were calculated from the perspective of the Chinese health-care payer. The utility data were taken from published studies. Sensitivity analyses were used to explore the impact of uncertainty factors in this cost-effectiveness analysis. RESULTS: Total direct costs of FOLFOX4 and XELOX per @entity1 were  19884.96    4280.30 and  18113.25    3122.20, respectively. The total fees related to adverse events per @entity1 during the entire treatment were  204.75    16.80 for the XELOX group, and  873.72    27.60 for the FOLFOX4 group, and the costs for travel and absenteeism per @entity1 were  18495.00 for the XELOX group and  21,352.68 for the FOLFOX4 group. The base-case analysis showed that FOLFOX4 was estimated to produce an additional 0.06 in quality adjusted life years (QALYs) at an additional cost of  3950.47 when compared to the XELOX regimen over the model time horizon. The cost per QALY gained was  8047.30 in the XELOX group, which was  900.98 less than in the FOLFOX4 group ( 8948.28). The one way sensitivity analysis demonstrated that the utility for the well state and minor @entity137 state greatly influenced the incremental cost-effectiveness ratio of FOLFOX4. CONCLUSION: In term of cost-comparison, XELOX is expected to dominate FOLFOX4 regimes; Therefore, XELOX provides a more cost-effective adjuvant chemotherapy for @entity694 @entity1 in China.
