Cost-effectiveness of novel predictive tests in the treatment of metastatic colorectal cancer: An analysis from a Swiss perspective.

Abstract

e16549 Background: monoclonal antibodies against the epidermal growth factor receptor (EGFR), like cetuximab, have led to significant clinical benefits for metastatic colorectal cancer (mCRC) patients but have also increased treatment costs considerably. Recent evidence associates KRAS and BRAF mutations with resistance to EGFR antibodies. We assessed the cost-effectiveness of testing for KRAS and BRAF mutations, prior to cetuximab treatment of chemorefractory mCRC patients, from a Swiss third party payer perspective. Methods: A life-long Markov cohort simulation model was used to estimate direct medical costs costs (€) and clinical effectiveness (quality adjusted life years, QALYs) of following strategies: KRAS testing, KRAS testing with subsequent BRAF testing of KRAS wildtypes (KRAS/BRAF), cetuximab without testing. Comparison was against a reference strategy of no cetuximab treatment. In the testing strategies, cetuximab treatment was initiated if no mutations were detected. Best supportive care was g...