Real-world cost-effectiveness of cetuximab in the third-line treatment of metastatic colorectal cancer based on patient chart review in the Netherlands

Carin A. Uyl- de Groot (), Elisabeth M. van Rooijen (), Cornelis J. A. Punt () and Chris P. Pescott ()
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Carin A. Uyl- de Groot: Erasmus University Rotterdam
Elisabeth M. van Rooijen: Erasmus University Rotterdam
Cornelis J. A. Punt: Academic Medical Center, University of Amsterdam
Chris P. Pescott: Global Evidence & Value Development, Merck KGaA

Health Economics Review, 2018, vol. 8, issue 1, 1-8

Abstract: Abstract Objective To assess the cost effectiveness of cetuximab in third-line treatment of patients with KRAS wild-type (wt) metastatic colorectal cancer (mCRC) in routine clinical practice compared with best supportive care (BSC). Methods Patients (n = 287) with KRAS wt mCRC treated with cetuximab or BSC in eight hospitals in the Netherlands between 2009 and 2012 were included in our real-world study. Outcome measures were costs per life-year (LY) and costs per quality-adjusted LY (QALY) gained. A Markov model was developed, and a time horizon of four years was applied. Outcomes were calculated from Kaplan-Meier survival curves from patient-level data and literature. Direct medical costs were estimated in all centers (2013 values), and incremental cost-effectiveness ratios (ICERs) were calculated. Results were discounted, and a probabilistic sensitivity analysis was performed. Results Administration of cetuximab in third-line treatment of mCRC resulted in a gain of 0.29 LYs and 0.25 QALYs compared with BSC. In the four-year study period, average discounted healthcare costs were €36,637 in the cetuximab group vs. €3648 in the BSC group. The discounted ICERs of cetuximab vs. BSC in the real-world setting were €114,907and €133,527 per LY and QALY gained, respectively. Conclusions Results of this cost-effectiveness analysis showed that third-line treatment with cetuximab for patients with KRAS (exon 2) wt mCRC offered clinical benefits at additional cost. The real-world ICERs were in line with those of previously published cetuximab and panitumumab cost-utility models.

Keywords: Cost effectiveness; Metastatic colorectal cancer; Cetuximab; KRAS; Third-line treatment (search for similar items in EconPapers)
Date: 2018
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DOI: 10.1186/s13561-018-0197-3

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