Five-year survival and costs of care in metastatic colorectal cancer: conventional versus monoclonal antibody-based treatment protocols

Abstract

Aim: To evaluate the costs and survival estimates of metastatic colorectal carcinoma patients treated with conventional cytostatic protocols and adjuvant monoclonal antibodies (mAbs). Methods: Retrospective randomized case series and cost-of-illness analysis was used. Metastatic colorectal carcinoma cases (62) were randomly selected from the archive of the largest university military hospital in Southeastern Europe. Results: A 6-month longer survival was attributed to mAbs (p = 0.581). Conventional protocols incurred €5137 (95% CI: €3758–€6517) versus €22,113 (95% CI: €16,201–€28,025) total direct medical costs in mAb-based group. ICER of €32,108 per life year gained attributable to mAbs three-fold exceeded informal willingness to pay threshold of Serbia. Conclusion: mAbs adjuvant protocols had modest positive impact on 5-year survival rates. Costs were driven by targeted biologicals, but significantly higher costs of care were recorded in mAb-treated group in other domains, as well. More selective prescription and reimbursement criteria should be applied to increase cost–effectiveness of targeted oncology agents.