Oncotarget

Clinical Research Papers:

RAS testing and cetuximab treatment for metastatic colorectal cancer: a cost-effectiveness analysis in a setting with limited health resources

Bin Wu, Yuan Yao, Ke Zhang and Xuezhen Ma _

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Oncotarget. 2017; 8:71164-71172. https://doi.org/10.18632/oncotarget.17029

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Abstract

Bin Wu1, Yuan Yao2, Ke Zhang3 and Xuezhen Ma4

1Medical Decision and Economic Group, Department of Pharmacy, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, P.R. China

2Department of Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China

3Department of Medical Oncology, Qingdao Commercial Worker‘s Hospital, Qingdao, Shandong, P.R. China

4Department of Medical Oncology, Qingdao Central Hospital, The Second Affiliated Hospital of Qingdao University Medical College, Qingdao, Shandong, P.R. China

Correspondence to:

Xuezhen Ma, email: [email protected]

Keywords: colorectal cancer, cost-effectiveness, cetuximab, gene mutation

Received: August 12, 2016     Accepted: March 20, 2017     Published: April 11, 2017

ABSTRACT

PURPOSE: To 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.

RESULTS: 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 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.

METHODS: A 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.

CONCLUSIONS: RAS testing with cetuximab treatment is likely to be cost-effective for patients with mCRC when PAP is available in China.


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