Health economics: can we afford an unrestricted use of new biological agents in gastrointestinal oncology?

Abstract

To review pharmacoeconomic studies in gastrointestinal oncology published after January 2003 and to assess whether the use of the new biologic agents should be restricted by cost considerations. Chemotherapy is standard treatment for the most common gastrointestinal tumors. New biologic agents have recently been introduced with significant benefit. Given the high cost of these novel agents, the question arises as to whether these drugs should be made available without restrictions. For some drugs, results from economic evaluations are available, showing incremental cost-effectiveness ratios between 33 649 and 46 720 Euros. However, for the most expensive new drugs such as bevacizumab and cetuximab no data is available yet. However, it is expected that the incremental cost-effectiveness ratio will be much higher. In our opinion incremental cost-effectiveness ratios between 45 000 Euros and 50 000 Euros per quality adjusted life year gained, should be acceptable for gastrointestinal cancer patients. We strongly recommend to authorities to be more willing to reimburse new cancer drugs for patients to benefit and that the pharmaceutical companies will be more prudent in their price setting. There are many new promising (biologic) agents available for patients with gastrointestinal cancer. The availability of these drugs for patients becomes more and more dependent on economic reasons.