Cetuximab Plus Chemotherapy versus Chemotherapy Alone in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Cost-Effectiveness Analysis.

Abstract

ObjectiveThe EXTREME clinical trial revealed that cetuximab plus chemotherapy improved the overall survival time of patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) versus chemotherapy alone. The current study examined the cost-effectiveness of cetuximab plus chemotherapy compared with chemotherapy alone in HNSCC patients from the perspective of China.Materials and MethodsA partitioned survival model was implemented for R/M HNSCC patients. Survival information was derived from the CHANGE-2 trial. The model was designed as a ten-year time horizon, a 3-week cycle, and a 3% discount rate for costs and utilities. An incremental cost-effectiveness ratio (ICER) value is less than $30,201/quality-adjusted life-year (QALY) was considered cost-effective in China. We analyzed the uncertainty by performing one-way and probabilistic sensitivity analyses.ResultsIn the base-case analysis, we found that the ICER of cetuximab plus chemotherapy compared with chemotherapy alone is $172,702/QALY. The results of one-way sensitivity analysis and probabilistic analysis showed that the fluctuations of each variable in its ranges do not cause ICERs to reach acceptable thresholds.ConclusionThe current observations suggested that treatment with cetuximab plus chemotherapy is not a cost-effective strategy for R/M HNSCC patients in China at a $30,201 willingness to pay threshold.