Cost-Effectiveness Analysis of Monoclonal Antibodies Associated With Chemotherapy in First-Line Treatment of Metastatic Colorectal Cancer

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dc.contributor.authorBarufaldi, Laura A.
dc.contributor.authorAlbuquerque, Rita de C.R. de
dc.contributor.authorNascimento, Aline do
dc.contributor.authorMartins, Luís Felipe L.
dc.contributor.authorZimmermann, Ivan R.
dc.contributor.authorSouza, Mirian C. de
dc.date.accessioned2024-11-11T16:52:42Z
dc.date.available2024-11-11T16:52:42Z
dc.date.issued2023
dc.description.abstractObjectives: This study aimed to evaluate the cost-effectiveness of anti–epidermal growth factor receptor (cetuximab and panitumumab) or anti–vascular endothelial growth factor (bevacizumab) monoclonal antibodies associated with conventional chemotherapy (CT) (fluorouracil and leucovorin with irinotecan) as a first-line treatment for unresectable metastatic colorectal cancer. Methods: A partitioned survival analysis model was adopted to simulate direct health costs and benefits comparing thera- peutic options in a 10 years’ time horizon. Model data were extracted from the literature and costs were obtained from Brazilian official government databases. The analysis considered the perspective of the Brazilian Public Health System; costs were measured in local currency (BRL) and benefits in quality-adjusted life-years (QALY). A 5% discount rate was applied to costs and benefits. Alternative willingness-to-pay scenarios, varying from 3 to 5 times the cost-effectiveness threshold established in Brazil, were estimated. The results were presented incremental cost-effectiveness ratio (ICER), and both deterministic and probabilistic sensitivity analyses were performed. Results: The most cost-effective choice would be the association of CT with panitumumab, with an ICER of $58 330.15/QALY compared with isolated CT. The second-best option was CT with bevacizumab and panitumumab, with an ICER of $71 195.40/ QALY compared with panitumumab alone. Although having higher costs, the second-best option was the most effective. Both strategies were cost-effective in part of the Monte Carlo iterations, considering the 33 threshold. Conclusions: The therapeutic option CT 1 panitumumab 1 bevacizumab represents the most significant effectiveness gain in our study. It is the second-lowest cost-effectiveness, and this option includes monoclonal antibodies association for patients with and without KRAS mutation.
dc.identifier.citationBarufaldi LA, de Albuquerque RCR, do Nascimento A, Martins LFL, Zimmermann IR, de Souza MC. Cost-Effectiveness Analysis of Monoclonal Antibodies Associated With Chemotherapy in First-Line Treatment of Metastatic Colorectal Cancer. Value Health Reg Issues. 2023 Sep;37:33-40. doi: 10.1016/j.vhri.2023.04.003
dc.identifier.otherDOI: 10.1016/j.vhri.2023.04.003
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/585
dc.language.isoen
dc.publisherValue in Health Regional Issues
dc.subjectantibodiesen
dc.subjectcolorectal neoplasmsen
dc.subjectcost-effectiveness evaluationen
dc.subjecthealth evaluationen
dc.subjectmonoclonalen
dc.subjectneoplasm metastasisen
dc.titleCost-Effectiveness Analysis of Monoclonal Antibodies Associated With Chemotherapy in First-Line Treatment of Metastatic Colorectal Cancer
dc.typeArticle
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