Clinical and Cost Effectiveness of Bevacizumab + FOLFIRI Combination Versus FOLFIRI Alone as First-Line Treatment of Metastatic Colorectal Cancer in South Korea

Lee, Eui Kyung; Révil, Cédric; Ngoh, C.A.; Lister, J.; Kwon, Jeong Mi; Park, Mee Hye; Park, Seok Jin; Park, Young Suk; Shin, Sang Joon; Lee, Myung Ah; Lee, Nam Su; Zang, Dae Young; Bae, Eun Jin; Kang, Mi Jeong

doi:10.1016/j.clinthera.2012.05.001

Cited by 15 publications

(10 citation statements)

References 37 publications

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“…Other decision models of bevacizumab with irinotecan have provided similar estimates of 668,000 NOK/LYG (CAD$122,000/LYG), 8 ¥11.9M/LYG (CAD$123,500/LYG), 30 and CAD$139,000/QALY. 31 Lee and colleagues reported an ICER of 41.2M won per LYG (CAD$39,000/LYG), 32 but the survival projected by the model (1.2 LYG) is considerably longer than other results in the literature 33 and our findings here. A previous study by researchers in BC used preliminary observational data to build a health economic model following the funding of bevacizumab with either irinotecan- or oxaliplatin-based chemotherapy.…”

Section: Discussioncontrasting

confidence: 65%

Real-World Cost-Effectiveness of Bevacizumab With First-Line Combination Chemotherapy in Patients With Metastatic Colorectal Cancer: Population-Based Retrospective Cohort Studies in Three Canadian Provinces

Pataky

Beca

Tran

et al. 2021

MDM Policy & Practice

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Background. Real-world evidence can be a valuable tool when clinical trial data are incomplete or uncertain. Bevacizumab was adopted as first-line therapy for metastatic colorectal cancer (mCRC) based on significant survival improvements in initial clinical trials; however, survival benefit diminished in subsequent analyses. Consequently, there is uncertainty surrounding the cost-effectiveness of bevacizumab therapy achieved in practice. Objective. To assess real-world cost-effectiveness of first-line bevacizumab with irinotecan-based chemotherapy versus irinotecan-based chemotherapy alone for mCRC in British Columbia (BC), Saskatchewan, and Ontario, Canada. Methods. Using provincial cancer registries and linked administrative databases, we identified mCRC patients who initiated publicly funded irinotecan-based chemotherapy, with or without bevacizumab, in 2000 to 2015. We compared bevacizumab-treated patients to historical controls (treated before bevacizumab funding) and contemporaneous controls (receiving chemotherapy without bevacizumab), using inverse-probability-of-treatment weighting with propensity scores to balance baseline covariates. We calculated incremental cost-effectiveness ratios (ICER) using 5-year cost and survival adjusted for censoring, with bootstrapping to characterize uncertainty. We also conducted one-way sensitivity analysis for key drivers of cost-effectiveness. Results. The cohorts included 12,112 (Ontario), 1,161 (Saskatchewan), and 2,977 (BC) patients. Bevacizumab significantly increased treatment costs, with mean ICERs between $78,000 and $84,000/LYG (life-year gained) in the contemporaneous comparisons and $75,000 and $101,000/LYG in the historical comparisons. Reducing the cost of bevacizumab by 50% brought ICERs in all comparisons below $61,000/LYG. Limitations. Residual confounding in observational data may bias results, while the use of original list prices overestimates current bevacizumab cost. Conclusion. The addition of bevacizumab to irinotecan-based chemotherapy extended survival for mCRC patients but at significant cost. At original list prices bevacizumab can only be considered cost-effective with certainty at a willingness-to-pay threshold over $100,000/LYG, but price reductions or discounts have a significant impact on cost-effectiveness.

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Section: Discussioncontrasting

confidence: 65%

Real-World Cost-Effectiveness of Bevacizumab With First-Line Combination Chemotherapy in Patients With Metastatic Colorectal Cancer: Population-Based Retrospective Cohort Studies in Three Canadian Provinces

Pataky

Beca

Tran

et al. 2021

MDM Policy & Practice

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“…V japonské studii nákladové efektivity byla za přijatelnou považována pouze kombinace režimu CAPOX (oxaliplatina, kapecitabin) s bevacizumabem v 1. linii léčby mCRC (ICER 83 000 USD/ LYG), i když hranice ochoty platit není v Japonsku stanovena [24]. Podobně studie vypracovaná v Jižní Koreji připouští podání bevacizumabu v kombinaci s režimem FOLFIRI v 1. linii léčby mCRC jako nákladově efektivní, ačkoliv v této zemi není stanovena hranice ochoty platit [25]. Každá země má jiný systém zdravotní péče, a proto nelze závěry zahraničních studií jednoduše přejímat.…”

Section: Diskuzeunclassified

The Cost Study of First- line Treatment of Metastatic Colorectal Carcinoma with Bevacizumab- containing Regimen in the Czech Republic

Hradecká¹,

Říhová²,

Horová³

et al. 2014

Klin Onkol

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Východiska: Bevacizumab je rekombinantní chimérická monoklonální protilátka, která se selektivně váže na vaskulární endoteliální růstový faktor. Kombinace bevacizumabu s chemoterapií je hrazena v České republice u pacientů s metastazujícím kolorektálním karcinomem (metastatic colorectal cancer-mCRC) v 1. a vyšších liniích léčby. Pokusili jsme se proto s využitím dat z komplexního onkologického centra náklady na podání bevacizumabu v 1. linii stanovit. Soubor pacientů a metody: Celkem bylo v naší analýze hodnoceno 218 pacientů. Finanční náklady na výkony, medikaci a hospitalizaci byly kalkulovány od zahájení léčby bevacizumabem do doby hodnocení odpovědi nádoru na léčbu při využití RECIST kritérií (complete response-CR, partial response-PR, stable disease-SD, progressive disease-PD) a/ nebo do úmrtí. Všichni pacienti byli sledováni minimálně po dobu 28 měsíců nebo do úmrtí. Výsledky: Progrese byla zaznamenána u 194 pacientů (89 % souboru). Průměrné náklady v období do progrese onemocnění (PD; medián doby do progrese 9,1 měsíce) byly 1 002 076,30 Kč, přičemž největší podíl byl vynaložen na medikaci-průměrně 917 048,60 Kč na jednoho pacienta. Medián do dosažení protinádorové odpovědi (

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“…These differences seem to be attributed to the different drug prices in each country. As for molecular targeted agents, several economic evaluations of Bev have been reported by Shiroiwa et al, Tappenden et al, and Lee et al [ 15 , 27 , 28 ]. These studies showed that the cost-effectiveness of Bev is low.…”

Section: Discussionmentioning

confidence: 99%

Real-world cost analysis of chemotherapy for colorectal cancer in Japan: detailed costs of various regimens during the entire course of chemotherapy

Yajima

Shimizu

Sakamaki

et al. 2015

BMC Health Serv Res

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BackgroundVarious chemotherapy regimens for advanced colorectal cancer have been introduced to clinical practice in Japan over the past decade. The cost profiles of these regimens, however, remain unclear in Japan. To explore the detailed costs of different regimens used to treat advanced colorectal cancer during the entire course of chemotherapy in patients treated in a practical setting, we conducted a so-called “real-world” cost analysis.MethodA detailed cost analysis was performed retrospectively. Patients with advanced colorectal cancer who had received chemotherapy in a practical healthcare setting from July 2004 through October 2010 were extracted from the ordering system database of Showa University Hospital. Direct medical costs of chemotherapy regimens were calculated from the hospital billing data of the patients. The analysis was conducted from a payer’s perspective.ResultsA total of 30 patients with advanced colorectal cancer were identified. Twenty patients received up to second-line treatment, and 8 received up to third-line treatment. The regimens identified from among all courses of treatment in all patients were 13 oxaliplatin-based regimens, 31 irinotecan-based regimens, and 11 regimens including molecular targeted agents. The average (95 % confidence interval [95 % CI]) monthly cost during the overall period from the beginning of treatment to the end of treatment was 308,363 (258,792 to 357,933) Japanese yen (JPY). According to the type of regimen, the average monthly cost was 418,463 (357,413 to 479,513) JPY for oxaliplatin-based regimens, 215,499 (188,359 to 242,639) JPY for irinotecan-based regimens, and 705,460 (586,733 to 824,187) JPY for regimens including molecular targeted agents. Anticancer drug costs and hospital fees accounted for 50 to 77 % and 11 to 25 % of the overall costs of chemotherapy, respectively.ConclusionThe costs of irinotecan-based regimens were lower than those of oxaliplatin-based regimens and regimens including molecular targeted agents in Japan. Using a lower cost regimen for first-line treatment can potentially reduce the overall cost of chemotherapy. The main cost drivers were the anticancer drug costs and hospitalization costs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1253-x) contains supplementary material, which is available to authorized users.

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Clinical and Cost Effectiveness of Bevacizumab + FOLFIRI Combination Versus FOLFIRI Alone as First-Line Treatment of Metastatic Colorectal Cancer in South Korea

Cited by 15 publications

References 37 publications

Real-World Cost-Effectiveness of Bevacizumab With First-Line Combination Chemotherapy in Patients With Metastatic Colorectal Cancer: Population-Based Retrospective Cohort Studies in Three Canadian Provinces

Real-World Cost-Effectiveness of Bevacizumab With First-Line Combination Chemotherapy in Patients With Metastatic Colorectal Cancer: Population-Based Retrospective Cohort Studies in Three Canadian Provinces

The Cost Study of First- line Treatment of Metastatic Colorectal Carcinoma with Bevacizumab- containing Regimen in the Czech Republic

Real-world cost analysis of chemotherapy for colorectal cancer in Japan: detailed costs of various regimens during the entire course of chemotherapy

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