OBJECTIVES: To compare the costs of administering oral paclitaxel (oral-p) compared to IV paclitaxel (IV-p) as a second-line therapy for patients with advanced gastric cancer from a limited societal perspective in a South Korean environment.

METHODS: A micro-costing model was developed to calculate costs of administering oral-p compared to IV-p from a limited societal perspective (i.e., excluding productivity costs). Cost items considered included direct medical costs, including costs of physician visits and emergency room visits and those related to patients’ time and transportation. All unit costs were based on insurance reimbursement amounts from Health Insurance Review and Assessment Service in Korea and were converted from Korean Won (KRW) to 2019 US dollars. Healthcare utilization during treatment was obtained by interviewing medical doctors and patients as well as measuring time spent by patients using time and motion study. The time horizon of cost calculations was 3 months to match with the length of a chemotherapy cycle and costs were discounted at 5%. Sensitivity analyses were performed for most variables.

RESULTS: The total costs (excluding costs of the paclitaxel medication) of administering paclitaxel oral and IV for 3 months were $819 (KRW 975,578) and $2,047 (KRW 2,437,232), respectively. Direct medical costs were $583 (KRW 694,020) for oral and $950 (KRW 1,130,684) for IV. Patient time and transportation costs were $237 (KRW 281,558) for oral and $1,098 (KRW 1,306,548) for IV. These estimations exclude costs associated with productivity.

CONCLUSIONS: Switching from IV paclitaxel to oral paclitaxel could save costs related to medical, time, and transportation of up to $1,228 (KRW 1,461,653). Further studies should be performed to calculate the incremental cost effectiveness ratio of oral compared to IV paclitaxel after considering all relevant costs including productivity gains and measuring utility values of IV and oral administration.