Severe chemotherapy-induced diarrhea in patients with colorectal cancer: a cost of illness analysis |
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Authors: | George?Dranitsaris author-information" > author-information__contact u-icon-before" > mailto:gdranit@ca.inter.net" title=" gdranit@ca.inter.net" itemprop=" email" data-track=" click" data-track-action=" Email author" data-track-label=" " >Email author,Jean?Maroun,Amil?Shah |
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Affiliation: | (1) Cancer Care Ontario, 429 Danforth Ave, Suite 476, Toronto, M4K 1P1, Canada;(2) Ottawa Regional Cancer Centre, Ottawa, Canada;(3) British Columbia Cancer Centre, Vancouver, British Columbia, Canada |
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Abstract: | Background Diarrhea is common with many types of chemotherapy and can have a major impact on maintaining dose intensity and treatment effectiveness, and on overall health care resource consumption. In this study, a cost of illness analysis was conducted to estimate the overall economic impact of grade III/IV diarrhea in patients with colorectal cancer receiving adjuvant or palliative chemotherapy.Methods This was a retrospective cohort study of patients with colorectal cancer who had received fluoropyrimidines, irinotecan or oxaliplatin (or a combination of these) and had developed grade III or IV diarrhea. Data collection included patient demographics, disease-related information and healthcare resource utilization to manage the grade III/IV diarrhea event (n=96).Results Grade III/IV diarrhea developed after the first cycle of chemotherapy in 54.2% of patients and was responsible for a median dose reduction and delay of 20% and 7 days, respectively. Overall, 31 of 96 patients (32.3%) required a hospital admission for supportive care with an 8-day median length of stay (range 2 to 28 days). When the economic impact of the grade III/IV diarrhea was quantified, the mean cost was Can $2559 per patient (95%CI: $1665 to 3453). A logistic regression analysis identified grade IV diarrhea (OR 11.2; P<0.001) and severe diarrhea developing after the first chemotherapy cycle (OR 3.1; P=0.051) as being significantly associated with patient hospitalization.Conclusions Grade III/IV diarrhea is a debilitating and costly complication of chemotherapy in colorectal cancer. Effective interventions that prevent the development of severe diarrhea need to be identified to save health-care costs and reduce patient morbidity.Funding for this study was provided by an unrestricted research grant from Novartis Pharmaceuticals Canada Inc. |
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Keywords: | Diarrhea Chemotherapy Colorectal cancer Cost analysis |
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