Abstract
PURPOSETo test the cost-effectiveness of cetuximab plus irinotecan, fluorouracil, and leucovorin (FOLFIRI) as first-line treatment in patients with metastatic colorectal cancer (mCRC) from a Chinese medical insurance perspective.RESULTSBaseline analysis showed that the addition of cetuximab increased quality-adjusted life-years (QALYs) by 0.63, an increase of $17,086 relative to FOLFIRI chemotherapy, resulting in an incremental cost-effectiveness ratio (ICER) of $27,145/QALY. When the patient assistance program (PAP) was available, the ICER decreased to $14,049/QALY, which indicated that the cetuximab is cost-effective at a willingness-to-pay threshold of China ($22,200/QALY). One-way sensitivity analyses showed that the median overall survival time for the cetuximab was the most influential parameter.METHODSA Markov model by incorporating clinical, utility and cost data was developed to evaluate the economic outcome of cetuximab in mCRC. The lifetime horizon was used, and sensitivity analyses were carried out to test the robustness of the model results. The impact of PAP was also evaluated in scenario analyses.CONCLUSIONSRAS testing with cetuximab treatment is likely to be cost-effective for patients with mCRC when PAP is available in China.
Highlights
Colorectal cancer (CRC) is one of the most common human malignancies and a leading cause of cancer-related death worldwide in developed countries [1]
Baseline analysis showed that the addition of cetuximab increased quality-adjusted life-years (QALYs) by 0.63, an increase of $17,086 relative to FOLFIRI chemotherapy, resulting in an incremental cost-effectiveness ratio (ICER) of $27,145/ QALY
When the patient assistance program (PAP) was available, the ICER decreased to $14,049/QALY, which indicated that the cetuximab is cost-effective at a willingnessto-pay threshold of China ($22,200/QALY)
Summary
Colorectal cancer (CRC) is one of the most common human malignancies and a leading cause of cancer-related death worldwide in developed countries [1]. 15% of CRC patients are diagnosed with metastatic disease at the time of diagnosis, and nearly half of these patients develop metastases during the course of their disease [3]. Despite the improvements in diagnosis and treatment, metastatic colorectal cancer (mCRC) remains an incurable disease with a 2-year median overall survival time [4]. New treatments for mCRC are necessary to improve the poor clinical outcomes. The clinical benefits of monoclonal antibodies to epidermal growth factor receptor (EGFR), including cetuximab and panitumumab, combined with chemotherapy or monotherapy in mCRC patients have been shown [5].
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