Cetuximab in first line treatment of metastatic colorectal cancer
The present health technology assessment report evaluates the clinical and economic profile of cetuximab in first-line metastatic colorectal cancer (mCRC) in Italy. The first part of the report addresses the epidemiological, clinical, social and economic impact of mCRC. In the second part, evidence...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SEEd Medical Publishers
2012-07-01
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| Series: | Farmeconomia: Health Economics and Therapeutic Pathways |
| Subjects: | |
| Online Access: | https://journals.seedmedicalpublishers.com/index.php/FE/article/view/305 |
| _version_ | 1818559837226663936 |
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| author | Carlo Barone Andrea Belisari Fortunato Ciardiello Lorenzo Mantovani Lucia D’Angiolella Gianluca Furneri Nicola Normanno Patrizio Piacentini Carmine Pinto |
| author_facet | Carlo Barone Andrea Belisari Fortunato Ciardiello Lorenzo Mantovani Lucia D’Angiolella Gianluca Furneri Nicola Normanno Patrizio Piacentini Carmine Pinto |
| author_sort | Carlo Barone |
| collection | DOAJ |
| description | The present health technology assessment report evaluates the clinical and economic profile of cetuximab in first-line metastatic colorectal cancer (mCRC) in Italy. The first part of the report addresses the epidemiological, clinical, social and economic impact of mCRC. In the second part, evidence of efficacy, safety and cost-effectiveness of cetuximab and its available alternatives is shown. Finally, a model-based economic evaluation aimed at comparing cetuximab-based regimens vs. alternative therapeutic strategies indicated in mCRC in Italy is presented. The model estimates the incremental cost-effectiveness of adding cetuximab to FOLFOX-4 or FOLFIRI based on KRAS status, vs. adding bevacizumab to FOLFOX-4 or vs. FOLFOX-4 or FOLFIRI alone. A theoretical analysis vs. panitumumab has also been performed, despite panitumumab is not yet reimbursed in Italy in first-line mCRC. Survival outcomes, quality of life and costs of patient management are estimated through a Markov model, using the Italian National Healthcare Service (NHS) perspective, over a 10 year period, taking into account KRAS status of patients. The results of the pharmaco-economic analysis show that cetuximab + FOLFOX-4 and cetuximab + FOLFIRI are associated with increased survival, increased cost and increased quality adjusted survival, compared to all other treatments currently indicated and reimbursed in Italy. Adding cetuximab to FOLFOX-4 or FOLFIRI, based on KRAS status shows favorable incremental cost-effectiveness ratio (ICER) vs. adding bevacizumab to FOLFIRI or vs. FOLFOX-4 or FOLFIRI alone. ICER of cetuximab (in combination with FOLFOX-4 or FOLFIRI), compared to currently reimbursed alternatives, is estimated between 6 and 13 thousand Euros per QALY gained, depending on alternative treatment. These estimates are robust in extensive sensitivity analyses. As a final result, both clinical and economic evidence analyzed in this health technology assessment leads to recommend cetuximab as preferred option for the first-line treatment of mCRC KRAS wild-type patients in Italy. |
| first_indexed | 2024-12-14T00:30:43Z |
| format | Article |
| id | doaj.art-aed409f9942b477087115ec46c5b46f7 |
| institution | Directory Open Access Journal |
| issn | 2240-256X |
| language | English |
| last_indexed | 2024-12-14T00:30:43Z |
| publishDate | 2012-07-01 |
| publisher | SEEd Medical Publishers |
| record_format | Article |
| series | Farmeconomia: Health Economics and Therapeutic Pathways |
| spelling | doaj.art-aed409f9942b477087115ec46c5b46f72022-12-21T23:24:52ZengSEEd Medical PublishersFarmeconomia: Health Economics and Therapeutic Pathways2240-256X2012-07-01131S18010.7175/fe.v13i1S.305274Cetuximab in first line treatment of metastatic colorectal cancerCarlo Barone0Andrea Belisari1Fortunato Ciardiello2Lorenzo Mantovani3Lucia D’Angiolella4Gianluca Furneri5Nicola Normanno6Patrizio Piacentini7Carmine Pinto8Università Cattolica del Sacro Cuore, RomaFondazione Charta, MilanoSeconda Università di NapoliUniversità degli Studi di Napoli Federico IIFondazione Charta, MilanoFondazione Charta, MilanoIstituto Nazionale Tumori, IRCCS Fondazione Pascale, NapoliAzienda Ospedaliera San Carlo Borromeo, MilanoAzienda Ospedaliero‑Universitaria di BolognaThe present health technology assessment report evaluates the clinical and economic profile of cetuximab in first-line metastatic colorectal cancer (mCRC) in Italy. The first part of the report addresses the epidemiological, clinical, social and economic impact of mCRC. In the second part, evidence of efficacy, safety and cost-effectiveness of cetuximab and its available alternatives is shown. Finally, a model-based economic evaluation aimed at comparing cetuximab-based regimens vs. alternative therapeutic strategies indicated in mCRC in Italy is presented. The model estimates the incremental cost-effectiveness of adding cetuximab to FOLFOX-4 or FOLFIRI based on KRAS status, vs. adding bevacizumab to FOLFOX-4 or vs. FOLFOX-4 or FOLFIRI alone. A theoretical analysis vs. panitumumab has also been performed, despite panitumumab is not yet reimbursed in Italy in first-line mCRC. Survival outcomes, quality of life and costs of patient management are estimated through a Markov model, using the Italian National Healthcare Service (NHS) perspective, over a 10 year period, taking into account KRAS status of patients. The results of the pharmaco-economic analysis show that cetuximab + FOLFOX-4 and cetuximab + FOLFIRI are associated with increased survival, increased cost and increased quality adjusted survival, compared to all other treatments currently indicated and reimbursed in Italy. Adding cetuximab to FOLFOX-4 or FOLFIRI, based on KRAS status shows favorable incremental cost-effectiveness ratio (ICER) vs. adding bevacizumab to FOLFIRI or vs. FOLFOX-4 or FOLFIRI alone. ICER of cetuximab (in combination with FOLFOX-4 or FOLFIRI), compared to currently reimbursed alternatives, is estimated between 6 and 13 thousand Euros per QALY gained, depending on alternative treatment. These estimates are robust in extensive sensitivity analyses. As a final result, both clinical and economic evidence analyzed in this health technology assessment leads to recommend cetuximab as preferred option for the first-line treatment of mCRC KRAS wild-type patients in Italy.https://journals.seedmedicalpublishers.com/index.php/FE/article/view/305cetuximabmetastatic colorectal cancerhealth technology assessment |
| spellingShingle | Carlo Barone Andrea Belisari Fortunato Ciardiello Lorenzo Mantovani Lucia D’Angiolella Gianluca Furneri Nicola Normanno Patrizio Piacentini Carmine Pinto Cetuximab in first line treatment of metastatic colorectal cancer Farmeconomia: Health Economics and Therapeutic Pathways cetuximab metastatic colorectal cancer health technology assessment |
| title | Cetuximab in first line treatment of metastatic colorectal cancer |
| title_full | Cetuximab in first line treatment of metastatic colorectal cancer |
| title_fullStr | Cetuximab in first line treatment of metastatic colorectal cancer |
| title_full_unstemmed | Cetuximab in first line treatment of metastatic colorectal cancer |
| title_short | Cetuximab in first line treatment of metastatic colorectal cancer |
| title_sort | cetuximab in first line treatment of metastatic colorectal cancer |
| topic | cetuximab metastatic colorectal cancer health technology assessment |
| url | https://journals.seedmedicalpublishers.com/index.php/FE/article/view/305 |
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