This resulted in increased costs for chemotherapy administration in the 5-FU/LV arm compared with the capecitabine treatment arm (��5151 and ��419, respectively). Thus, considering both drugs and their administration, chemotherapy costs are lower by ��3253 (57% lower) for capecitabine vs 5-FU/LV. Figure 1 Number of treatment visits for chemotherapy these administration or AEs with capecitabine vs 5-FU/LV. Cost of managing AEs The improved safety profile with capecitabine compared with 5-FU/LV was reflected in the need for fewer costly medications for the management of treatment-related AEs in the capecitabine treatment arm compared with 5-FU/LV (Table 2). In particular, capecitabine reduced the need for the more expensive drugs, such as fluconazole for stomatitis, 5-HT3 antagonists for nausea/vomiting and cytokines for neutropenia.

Overall, the mean cost of medication for management of AEs was lower in the capecitabine arm compared with the 5-FU/LV arm (��86 and ��345, respectively). Table 2 Medications used for management of treatment-related adverse events A similar mean number of physician visits due to AEs were seen in each treatment arm (1.93 and 1.92 for capecitabine and i.v. 5-FU/LV, respectively). However, there were 16% fewer AE-related hospital admissions and 15% fewer days in hospital in the capecitabine treatment arm vs the i.v. 5-FU/LV arm (10.6 and 12.8 admissions, respectively, and 113 vs 130 days, respectively; Figure 2). The mean cost of hospitalisations was consequently lower with capecitabine than with 5-FU/LV (��399 vs ��459), although the cost of physician consultations was slightly increased with capecitabine compared with 5-FU/LV (��154 vs ��145).

In accordance with these findings, the projected ambulance costs would be reduced in the capecitabine group compared with the 5-FU/LV group (��38 vs ��126). Figure 2 Hospital admissions for AEs. Societal costs for time and travel The projected mean number of hours per patient required for travel were lower in the capecitabine group compared with the 5-FU/LV group (27 and 125h, respectively) and the mean costs for travel time were therefore reduced in the capecitabine group (��320 compared with ��1503 in the 5-FU/LV group). Similarly, the mean travel cost per patient was reduced with capecitabine compared with 5-FU/LV (��62 and ��196, respectively).

Total costs Direct costs during the treatment period have been grouped into six components, as illustrated in Table 3. The major drivers for the cost analysis are the cost of the chemotherapy drugs and the cost of administration of treatment. The additional ��4732 required Drug_discovery for i.v. therapy is more than three times the additional acquisition cost of capecitabine. With respect to the management of AEs, the most notable difference was the lower cost of medication used for treating AEs in the capecitabine arm (��86 compared with ��345 in the 5-FU/LV arm).