Document Type: Original Article

Authors

1 Student Research Committee, Department of Health Economics, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran

2 Hematology Research Center, Hematology and Oncology Ward, Shiraz University of Medical Sciences, Shiraz, Iran

3 Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Cancer is one of the major causes of mortality and as an effective
factor in the burden of diseases for the future. Among all cancers, gastric cancer is the
fourth most common and the second leading cause of cancer mortality worldwide. In
this study, we aim to evaluate the cost-utility of two chemotherapy regimens –
epirubicin, oxaliplatin, and capecitabine versus docetaxel, cisplatin, and fluorouracil
in patients with advanced gastric cancer in a hospital in southern Iran.
Method: This cross-sectional study was an economic evaluation of cost-utility type
that included all patients at Amir Hospital (Shiraz, Iran) who had advanced gastric cancer
and received either the epirubicin, oxaliplatin, and capecitabine or docetaxel, cisplatin,
and fluorouracil chemotherapy regimen. All costs and the quality-adjusted life years
were calculated, followed by one-way sensitivity analysis to verify the results.
Results:A total of 54 patients participated in this study, amongst whom 20 received
the epirubicin, oxaliplatin, and capecitabine regimen and 34 received the docetaxel,
cisplatin, and fluorouracil regimen. The mean quality of life of patients that received
docetaxel, cisplatin, and fluorouracil was 0.747, whereas it was 0.836 for patients that
received epirubicin, oxaliplatin, and capecitabine. The docetaxel, cisplatin, and
fluorouracil treatment group ($5573) was more expensive than the epirubicin, oxaliplatin,
and capecitabine group ($3108). The results obtained from the cost-utility analysis
showed that the epirubicin, oxaliplatin, and capecitabine drug regimen was costeffective
due to lower cost and higher utility than the docetaxel, cisplatin, and
fluorouracil regimen. One-way sensitivity analysis confirmed the accuracy of these
results.
Conclusion: Due to the cost-effectiveness of the epirubicin, oxaliplatin, and
capecitabine drug regimen compared to docetaxel, cisplatin, and fluorouracil, we
recommend that oncologists use this regimen to treat gastric cancer patients.

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