A comparison of mortality and costs associated with FOLFOX versus FOLFIRI in stage IV XXXX .

@entity1 @entity901 @entity4181 @entity2600 @entity5 @entity14 @entity204 @entity1487
OBJECTIVE: To examine cost and mortality among stage IV @entity14 ( @entity14 ) @entity1 treated with @entity1487 (5FU)/ @entity4181 / @entity901 (FOLFOX) or 5FU/ @entity4181 / @entity2600 (FOLFIRI). METHODS: Adult @entity14 @entity1 newly treated with FOLFOX or FOLFIRI were identified from a large database using medical and pharmacy claims for services delivered January 1, 2002 through December 31, 2005. @entity5 stage for a subset of @entity1 was abstracted from medical records. Outcomes were annualized costs calculated for 4 years of observation, and @entity204 as recorded by the National @entity204 Index. Cost was analyzed using generalized linear modeling; mortality was modeled using Cox proportional hazards analysis. RESULTS: Unadjusted annualized median and mean costs were  134,401 and  152,213, respectively, for the FOLFOX cohort (n = 41) and  103,150 and  107,994 for the FOLFIRI cohort (n = 86). @entity204 occurred among five (12%) FOLFOX and 42 (53%) FOLFIRI @entity1 . Adjusted analysis revealed no significant difference in cost between cohorts, even after adjusting for reduced irinotecan costs due to generic availability. Incremental costs associated with one additional life saved per year were only  1,236 higher for @entity1 treated with FOLFOX compared with FOLFIRI. Cox analysis revealed a significant survival advantage for FOLFOX over FOLFIRI (HR = 5.2; 95% CI: 1.7-15.8). CONCLUSIONS: A significant survival benefit was seen for @entity14 @entity1 receiving FOLFOX versus FOLFIRI; multivariate analysis revealed no significant cost differences. However, the small sample size may have resulted in lack of adequate power to detect a difference between cohorts. There may be factors influencing mortality that were not included in the multivariate modeling.
