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Economic Analysis of Panitumumab Compared With Cetuximab in Patients With Wild-type KRAS Metastatic Colorectal Cancer That Progressed After Standard Chemotherapy
- Source :
- Clinical Therapeutics. 38(6):1376-1391
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Purpose In this analysis, we compared costs and explored the cost-effectiveness of subsequent-line treatment with cetuximab or panitumumab in patients with wild-type KRAS (exon 2) metastatic colorectal cancer (mCRC) after previous chemotherapy treatment failure. Data were used from ASPECCT (A Study of Panitumumab Efficacy and Safety Compared to Cetuximab in Patients With KRAS Wild-Type Metastatic Colorectal Cancer), a Phase III, head-to-head randomized noninferiority study comparing the efficacy and safety of panitumumab and cetuximab in this population. Methods A decision-analytic model was developed to perform a cost-minimization analysis and a semi-Markov model was created to evaluate the cost-effectiveness of panitumumab monotherapy versus cetuximab monotherapy in chemotherapy-resistant wild-type KRAS (exon 2) mCRC. The cost-minimization model assumed equivalent efficacy (progression-free survival) based on data from ASPECCT. The cost-effectiveness analysis was conducted with the full information (uncertainty) from ASPECCT. Both analyses were conducted from a US third-party payer perspective and calculated average anti–epidermal growth factor receptor doses from ASPECCT. Costs associated with drug acquisition, treatment administration (every 2 weeks for panitumumab, weekly for cetuximab), and incidence of infusion reactions were estimated in both models. The cost-effectiveness model also included physician visits, disease progression monitoring, best supportive care, and end-of-life costs and utility weights estimated from EuroQol 5-Dimension questionnaire responses from ASPECCT. Findings The cost-minimization model results demonstrated lower projected costs for patients who received panitumumab versus cetuximab, with a projected cost savings of $9468 (16.5%) per panitumumab-treated patient. In the cost-effectiveness model, the incremental cost per quality-adjusted life-year gained revealed panitumumab to be less costly, with marginally better outcomes than cetuximab. Implications These economic analyses comparing panitumumab and cetuximab in chemorefractory wild-type KRAS (exon 2) mCRC suggest benefits in favor of panitumumab. ClinicalTrials.gov identifier: NCT01001377.
- Subjects :
- Adult
subsequent-line
Oncology
medicine.medical_specialty
Colorectal cancer
Cost effectiveness
Cost-Benefit Analysis
medicine.medical_treatment
Population
Antineoplastic Agents
colorectal cancer
medicine.disease_cause
Disease-Free Survival
Proto-Oncogene Proteins p21(ras)
03 medical and health sciences
0302 clinical medicine
Internal medicine
cetuximab
cost-minimization
medicine
Humans
Panitumumab
Pharmacology (medical)
030212 general & internal medicine
Neoplasm Metastasis
education
cost-effectiveness
neoplasms
health care economics and organizations
Pharmacology
Chemotherapy
education.field_of_study
Cetuximab
business.industry
Incidence (epidemiology)
Antibodies, Monoclonal
Exons
medicine.disease
digestive system diseases
Surgery
030220 oncology & carcinogenesis
Quality-Adjusted Life Years
KRAS
Colorectal Neoplasms
panitumumab
business
medicine.drug
Subjects
Details
- ISSN :
- 01492918
- Volume :
- 38
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Clinical Therapeutics
- Accession number :
- edsair.doi.dedup.....7186ec68514f22b782688398d9e34d93
- Full Text :
- https://doi.org/10.1016/j.clinthera.2016.03.023