Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer.
To assess the cost effectiveness of adding cetuximab to platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) from the perspective of the Canadian public healthcare system.We developed a Markov state transition mode...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2012-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3379991?pdf=render |
| _version_ | 1818505991345405952 |
|---|---|
| author | Malek B Hannouf Chander Sehgal Jeffrey Q Cao Joseph D Mocanu Eric Winquist Gregory S Zaric |
| author_facet | Malek B Hannouf Chander Sehgal Jeffrey Q Cao Joseph D Mocanu Eric Winquist Gregory S Zaric |
| author_sort | Malek B Hannouf |
| collection | DOAJ |
| description | To assess the cost effectiveness of adding cetuximab to platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) from the perspective of the Canadian public healthcare system.We developed a Markov state transition model to project the lifetime clinical and economic consequences of recurrent or metastatic HNSCC. Transition probabilities were derived from a phase III trial of cetuximab in patients with recurrent or metastatic HNSCC. Cost estimates were obtained from London Health Sciences Centre and the Ontario Case Costing Initiative, and expressed in 2011 CAD. A three year time horizon was used. Future costs and health benefits were discounted at 5%.In the base case, cetuximab plus platinum-based chemotherapy compared to platinum-based chemotherapy alone led to an increase of 0.093 QALY and an increase in cost of $36,000 per person, resulting in an incremental cost effectiveness ratio (ICER) of $386,000 per QALY gained. The cost effectiveness ratio was most sensitive to the cost per mg of cetuximab and the absolute risk of progression among patients receiving cetuximab.The addition of cetuximab to standard platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic HNSCC has an ICER that exceeds $100,000 per QALY gained. Cetuximab can only be economically attractive in this patient population if the cost of cetuximab is substantially reduced or if future research can identify predictive markers to select patients most likely to benefit from the addition of cetuximab to chemotherapy. |
| first_indexed | 2024-12-10T21:58:23Z |
| format | Article |
| id | doaj.art-643c8639627147e4a108144f0d30bcf0 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T21:58:23Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-643c8639627147e4a108144f0d30bcf02022-12-22T01:31:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0176e3855710.1371/journal.pone.0038557Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer.Malek B HannoufChander SehgalJeffrey Q CaoJoseph D MocanuEric WinquistGregory S ZaricTo assess the cost effectiveness of adding cetuximab to platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) from the perspective of the Canadian public healthcare system.We developed a Markov state transition model to project the lifetime clinical and economic consequences of recurrent or metastatic HNSCC. Transition probabilities were derived from a phase III trial of cetuximab in patients with recurrent or metastatic HNSCC. Cost estimates were obtained from London Health Sciences Centre and the Ontario Case Costing Initiative, and expressed in 2011 CAD. A three year time horizon was used. Future costs and health benefits were discounted at 5%.In the base case, cetuximab plus platinum-based chemotherapy compared to platinum-based chemotherapy alone led to an increase of 0.093 QALY and an increase in cost of $36,000 per person, resulting in an incremental cost effectiveness ratio (ICER) of $386,000 per QALY gained. The cost effectiveness ratio was most sensitive to the cost per mg of cetuximab and the absolute risk of progression among patients receiving cetuximab.The addition of cetuximab to standard platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic HNSCC has an ICER that exceeds $100,000 per QALY gained. Cetuximab can only be economically attractive in this patient population if the cost of cetuximab is substantially reduced or if future research can identify predictive markers to select patients most likely to benefit from the addition of cetuximab to chemotherapy.http://europepmc.org/articles/PMC3379991?pdf=render |
| spellingShingle | Malek B Hannouf Chander Sehgal Jeffrey Q Cao Joseph D Mocanu Eric Winquist Gregory S Zaric Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer. PLoS ONE |
| title | Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer. |
| title_full | Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer. |
| title_fullStr | Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer. |
| title_full_unstemmed | Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer. |
| title_short | Cost-effectiveness of adding cetuximab to platinum-based chemotherapy for first-line treatment of recurrent or metastatic head and neck cancer. |
| title_sort | cost effectiveness of adding cetuximab to platinum based chemotherapy for first line treatment of recurrent or metastatic head and neck cancer |
| url | http://europepmc.org/articles/PMC3379991?pdf=render |
| work_keys_str_mv | AT malekbhannouf costeffectivenessofaddingcetuximabtoplatinumbasedchemotherapyforfirstlinetreatmentofrecurrentormetastaticheadandneckcancer AT chandersehgal costeffectivenessofaddingcetuximabtoplatinumbasedchemotherapyforfirstlinetreatmentofrecurrentormetastaticheadandneckcancer AT jeffreyqcao costeffectivenessofaddingcetuximabtoplatinumbasedchemotherapyforfirstlinetreatmentofrecurrentormetastaticheadandneckcancer AT josephdmocanu costeffectivenessofaddingcetuximabtoplatinumbasedchemotherapyforfirstlinetreatmentofrecurrentormetastaticheadandneckcancer AT ericwinquist costeffectivenessofaddingcetuximabtoplatinumbasedchemotherapyforfirstlinetreatmentofrecurrentormetastaticheadandneckcancer AT gregoryszaric costeffectivenessofaddingcetuximabtoplatinumbasedchemotherapyforfirstlinetreatmentofrecurrentormetastaticheadandneckcancer |