Cost-Effectiveness of Adjuvant Chemotherapy in the Treatment of Early-Stage Colon Cancer

Several adjuvant chemotherapy regimens exist for the treatment of stage III colon cancer. In conjunction with the clinical data from randomized trials, cost-effectiveness studies might help to inform the selection of the optimal treatment regimen. In this review, the outcomes from randomized clinical trials and the elements and process of a cost-effectiveness analysis in this setting are discussed. In addition, the data from several published cost-effectiveness analysis studies in the adjuvant setting are reviewed. In general, capecitabine-based regimens have been found to be less costly and more effective than 5-fluorouracil-based regimens. The combination of oxaliplatin leads to a modestly improved effectiveness and at an acceptable incremental cost. Future studies using data obtained outside the setting of a clinical trial might help to further guide selection of the most cost-effective regimen.