The CAP-CR study: Direct medical costs in Italian metastatic colorectal cancer patients on first-line infusional 5-fluorouracil or oral capecitabine

Aim: To describe the healthcare resource consumption of metastatic colorectal cancer (MCRC) patients in the Italian healthcare setting. Methods: A retrospective chart analysis estimating direct medical costs of first-line infusional 5-Fluorouracil (5-FU) or oral Capecitabine (CAP), associated or not with other chemotherapies, from the Italian Healthcare Service (IHCS) and Hospital (H) perspectives. Results: 202 subjects were analysed. CAP patients (N = 66) were older, with a more compromised clinical status and received less chemotherapy agents in association than 5-FU patients (N = 136). From the IHCS perspective, mean total costs per patient were €12,029 and €5,781 in the 5-FU and CAP arms respectively; €7,338 and €4,688 from the H perspective. The infusional administration route of 5-FU was a cost driver from both perspectives. Sensitivity analyses found the results to be robust to variations in base case parameters. Conclusions: Management of MCRC by oral chemotherapies may be an economically advantageous option to both IHCS and hospitals.