Bearne, A

Brown, R

De Cock, E

Sorensen, S

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PCN17: AN ANALYSIS OF RESOURCE USE IN THE TREATMENT OF ADVANCED COLORECTAL CANCER IN THE UK 

90 Abstracts
range of preferences occurred in the VAS, with the mean
score for severe nausea rated at 0.27, and anorexia at
0.82. The TTO and SG ranges were narrower than the
VAS (0.55 to 0.90, and 0.80 to 0.95, respectively). Con-
sistent with other studies, the lowest median score for all
three preference measures was severe nausea. CONCLU-
SION: Similar scores were obtained from the three meth-
ods to estimate preferences for cancer related health
states, although the narrowness of the TTO/SG distribu-
tions may limit the ability to distinguish between the 12
side-effects. The methods were not equivalent in ease of
administration as shown by the number of missing items
in the TTO/SG. Additional comparisons across these
three methods and different populations would assist in
determining the association between side effects and pref-
erences.
PCN16
CHEMOTHERAPY TREATMENT IN NEWLY 
DIAGNOSED BREAST CANCER PATIENTS IN A 
MANAGED CARE POPULATION
Yazdani C1, McLaughlin T1, Koos F2, Hansen J1
1NDC Health, Phoenix, AZ, USA; 2PharMetrics, Inc, 
Watertown, MA, USA
OBJECTIVE: To characterize the antineoplastic treat-
ment of newly diagnosed breast cancer patients in a man-
aged care population. METHODS: Adult subjects con-
tained within PharMetric’s Integrated Outcomes database
possessing a diagnosis of breast cancer (ICD-9-CM 
174) followed by a procedure code for chemotherapy
during 1997–1999 were eligible for study inclusion. Pa-
tients with diagnoses for other neoplasms and pre-diag-
nosis treatment were excluded. Utilization of antineo-
plastic agents, radiation therapy (RT) and mastectomy
during the 6-month post-diagnosis period was measured.
RESULTS: 6,652 patients met the inclusion criteria. The
mean age was 53.7 years. 3,396 (51.1%) patients re-
ceived RT, while 3,469 (52.2%) patients underwent mas-
tectomy. Patients 61 year of age and older were signifi-
cantly less likely to undergo RT or mastectomy as
compared to younger patients (p  0.0001). Doxorubicin
and cyclophosphamide were extensively used in younger
patients (ADR: 32.7% in 71 vs. 64.4% in 40; cyclo-
phosphamide: 53.3% in 71 vs. 73.2% in 71). In con-
trast, fluorouracil and methotrexate appeared to be the
drug of choice in elderly (5-FU: 49.1% in 71 vs. 33.3%
in 41; MTX: 30.9% in 71 vs. 19.8% in 41). Use of
paclitaxol was consistent across all age categories
(24.4%). Elderly were less likely to undergo partial mas-
tectomy (8.7% in 71 vs. 23.1% in 41). The difference
in the rate of modified radical mastectomy between age
groups was less pronounced (22.3% in 71 vs. 29.5% in
41). After adjusting for age, RT and health plan identi-
fier, the administration of cyclophosphamide or doxoru-
bicin was more likely to follow any mastectomy, while
the association between mastectomy and fluorouracil use
was limited to modified radical. RT was likely to be used
as adjunct therapy to all antineoplastics, with the excep-
tion of cyclophosphamide. CONCLUSIONS: The elderly
appeared to be treated less aggressively with anti-neo-
plastic agents. The choice of agent is governed by age and
the mode of other treatments.
PCN17
AN ANALYSIS OF RESOURCE USE IN THE 
TREATMENT OF ADVANCED COLORECTAL 
CANCER IN THE UK
Sorensen S1, Brown R1, De Cock E1, Bearne A2
1MEDTAP International Inc, Bethesda, MD, USA; 2Aventis 
Pharma, Kent, UK
OBJECTIVE: This study aims to estimate the non chemo-
therapy costs of treatment of advanced metastatic colo-
rectal cancer from the perspective of the UK National
Health Service. METHODS: Resource use collected dur-
ing comparative clinical trials often is insufficient in de-
termining the actual costs of patient management. Large
data bases can be used to estimate patient health care re-
source consumption, but these are not always available.
Soliciting expert opinion from clinicians may provide the
only reasonable data source. A questionnaire was devel-
oped to obtain resource utilization for routine treatment
and monitoring, adverse event management and other
clinical parameters in the first line setting. Responses
were obtained from five oncologists from various centres
in the UK with experience of treating advanced meta-
static colorectal cancer with chemotherapy. Data on sec-
ond line treatment came from resource use collected dur-
ing a trial. RESULTS: The clinicians estimated that 40%
of first line patients would receive only palliative care at
disease progression and 60% would receive second line
therapy. Resources included physicians, acute care ad-
missions, labs, hospice, palliative drugs, community
nurses and radiology.
CONCLUSIONS: Chemotherapy drug costs are only a
part of the costs incurred in treating advanced colorectal
cancer. These results clearly show the substantial non-
chemotherapy costs throughout the remaining life of pa-
tients that also need to be considered when treating these
patients.
Non-Chemotherapy Costs
Average cost/
patient/week £
One time cost for insertion of tunneled 
catheter at start of chemotherapy 250
Non chemotherapy costs during 1st line 
chemotherapy 485
Non chemotherapy costs during disease
remission (1st time) 116
Non chemotherapy costs during 2nd line
chemotherapy (derived from trial) 108
During Terminal Palliative Care 256


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PCN17: AN ANALYSIS OF RESOURCE USE IN THE TREATMENT OF ADVANCED COLORECTAL CANCER IN THE UK

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