#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Cost‑effectiveness Analysis of Panitumumab Plus mFOLFOX6 Compared to Bevacizumab Plus mFOLFOX6 for First‑line Treatment of Patients with Wild‑type RAS Metastatic Colorectal Cancer –  Czech Republic Model Adaptation


Authors: J. Fínek 1;  J. Skoupá 2;  P. Jandová 3
Authors‘ workplace: Onkologická a radioterapeutická klinika LF UK a FN Plzeň 1;  Medicínské datové centrum, 1. LF UK v Praze 2;  Amgen s. r. o., Praha 3
Published in: Klin Onkol 2015; 28(4): 265-272
Category: Original Articles
doi: https://doi.org/10.14735/amko2015265

Overview

Background:
Pharmacoeconomic assessments are a part of the decision process not only during reimbursement setting, but in clinical practice as well. The presented cost‑effectiveness analysis assesses panitumumab + mFOLFOX6 vs. bevacizumab + mFOLFOX6 in 1st line treatment of patients with wild‑type RAS metastatic colorectal cancer (mCRC) in the Czech environment.

Material and Methods:
The adaptation of a Markov model considers the health‑ care perspective; clinical data (efficacy, health‑ care utilization and adverse events) are derived from a head‑ to‑ head comparison (PEAK study). Health states included in the model: progression free on treatment, progression (with/ without active treatment), resection of metastases, disease‑free after successful resection and death. Actual reimbursement levels were used to estimate costs, published literature to estimate duration of 2nd line treatment. The analysis assumes a life‑ time horizon; uncertainty was limited by performing one‑ way and probabilistic sensitivity analyses. Analysis outcomes are life‑years gained (LYG) and quality‑adjusted life‑years (QALYs).

Results:
Panitumumab + mFOLFOX6 is more effective and more costly in 1st line patients with wild‑type RAS mCRC. Incremental costs per QALY are 837,270 CZK, per LYG 615,022 CZK; however, below the willingness‑to‑pay threshold applied in the Czech Republic.

Conclusions:
Panitumumab + mFOLFOX6 is cost‑effective in 1st line treatment of patients with wild‑type RAS mCRC compared to bevacizumab + mFOLFOX6 in the Czech setting.

Key words:
cost‑effectiveness –  panitumumab –  bavacizumab –  colorectal cancer

Co-author of the article Jandova P. is employed with Amgen s. r. o., Prague. She did not participate in the creation and validation of models, modeling and interpretation of results.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
22. 6. 2015

Accepted:
28. 7. 2015


Sources

1. Svod.cz [internetová stránka]. Český národní webový portál epidemiologie nádorů. Masarykova univerzita, Česká republika; [aktualizováno 13. července 2014; citováno 21. března 2015]. Dostupné z: http:/ / www.svod.cz.

2. Linkos. cz [internetová stránka]. Modrá kniha České onkologické společnosti ČLS JEP, Česká republika [aktualizováno 1. března 2015; citováno 21. března 2015]. Dostupné z: http:/ / www.linkos.cz/ files/ modra‑ kniha/ 13.pdf.

3. Schwartzberg LS, Rivera F, Karthaus M et al. PEAK: a randomized, multicenter phase II study of panitumumab plus modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) or bevacizumab plus mFOLFOX6 in patients with previously untreated, unresectable, wild‑ type KRAS exon 2 metastatic colorectal cancer. J Clin Oncol 2014; 32(21): 2248– 2247. doi: 10.1200/ JCO.2013.53.2473.

4. SUKL.cz [internetová stránka]. Státní ústav pro kontrolu léčiv; [aktualizováno 1. února 2013; citováno 21. března 2015]. Dostupné z: http:/ / www.sukl.cz/ file/ 73935_1_1a http:/ / www.sukl.cz/ file/ 79359_1_1.

5. Peeters M, Price T, Hotko Y et al. Randomized phase 3 study of panitumumab with FOLFIRI vs. FOLFIRI alone as second‑line treatment in patients with metastatic colorectal cancer. J Clin Oncol 2010; 28(31): 4706– 4713. doi: 10.1200/ JCO.2009.27.6055.

6. Giantonio BJ, Catalano PJ, Meropol NJ et al. Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 2007; 25(12): 1539– 1544.

7. Adam R, Delvart V, Pascal G et al. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long‑term survival. Ann Surg 2004; 240(4): 644– 657.

8. MZCR.cz [internetová stránka]. Ministerstvo zdravotnictví České republiky; [aktualizováno 20. prosince 2013 a 16. dubna 2014; citováno 21. března 2015]. Dostupné z: http:/ / www.mzcr.cz/ dokumenty/ vyhlaska‑ c421/ 2013– sb‑ _8573_1154_3.html a http:/ / www.mzcr.cz/ dokumenty/ metodicke‑ materialy‑ 2014_8590_1058_3.html.

9. Dolan P. Modeling valuations for EuroQol Health States. Med Care 1997; 35(11): 1085– 108.

Labels
Paediatric clinical oncology Surgery Clinical oncology
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#