Behandlungskosten fluoropyrimidin-basierter therapien des kolorektalen karzinoms in verschiedenen behandlungssituationen

Aims: 1. To identify the treatment costs of different standard fluoropyrimidine-based therapies, i. e. the Mayo Clinic and AIO/Ardalan regimens, under real-life conditions in settings routinely used for chemotherapy administration in Germany (inpatient, day-clinic or office-based oncologists). 2. To investigate the cost implications of routine use of capecitabine, an oral alternative for the treatment of metastatic colorectal cancer. Method: Analysis of actual fee-listings of office based oncologists and projection of results to several hospital-based treatment settings and to oral treatment with capecitabine. Results: Office-based setting: The highest quarterly treatment costs of 9,874 € were found for the AIO/Ardalan-regimen, followed by the Mayo Clinic-regimen, which incurred costs of 2,497 € The cheapest treatment option was capecitabine with quarterly costs of 1,610 €. Day-clinic setting: The costs of the Mayo-Clinic protocol amounted to 2,036 € in a municipal hospital and 8,455 € in an university hospital. The respective costs for the AlO/Ardalan regime were 1,294 € and 5,374 €. In-patient setting: Mayo-Clinic protocol costs were 3,143 € in a municipal hospital and 10,569 € in a university hospital. Respective costs found for the AIO/Ardalan-regimen were 1,998 € and 6,717 € Conclusion: From a pharmacoeconomic perspective, substantial cost savings for health insurances, without inducing losses by providers, may be realized, if patients are transferred from the hospital to the office-based setting and treated with capecitabine Further savings could be realized if drug prices in hospital and retail pharmacies were harmonized.