Real-world Direct Health Care Costs for Metastatic Colorectal Cancer Patients Treated With Cetuximab or Bevacizumab-containing Regimens in First-line or First-line Through Second-line Therapy

Johnston, Stephen S.; Wilson, Kathleen; Varker, Helen; Malangone-Monaco, Elisabetta; Juneau, Paul; Riehle, Ellen; Satram‐Hoang, Sacha; Sommer, Nicolas; Ogale, Sarika

doi:10.1016/j.clcc.2017.03.014

Cited by 11 publications

(7 citation statements)

References 5 publications

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“…However, treatment costs are increased substantially when a monoclonal antibody is added to conventional treatment, for example adding bevacizumab increases the cost per cycle by €811,31 and cetuximab by €1342,73. This result is in line with previous studies that show a lower cost of first-and second-line treatment with bevacizumab-containing regimens in comparison to cetuximab-containing regimens despite a similar efficacy [55][56][57][58]. This cost difference has shown to be more than $2000 per month per patient and alludes to a better value offering for funders [55][56][57][58].…”

Section: Discussionsupporting

confidence: 90%

Colorectal Cancer (CRC) treatment and associated costs in the public sector compared to the private sector in Johannesburg, South Africa

Herbst

Miot

Moch

et al. 2020

BMC Health Serv Res

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Background: South Africa's divided healthcare system is believed to be inequitable as the population serviced by each sector and the treatment received differs while annual healthcare expenditure is similar. The appropriateness of treatment received and in particular the cost of the same treatment between the sectors remains debatable and raises concerns around equitable healthcare. Colorectal cancer places considerable pressure on the funders, yet treatment utilization data and the associated costs of non-communicable diseases, in particular colorectal cancer, are limited for South Africa. Resources need to be appropriately managed while ensuring equitable healthcare is provided regardless of where the patient is able to receive their treatment. Therefore the aim of this study was to determine the cost of colorectal cancer treatment in a privately insured patient population in order to compare the costs and utilization to a previously published public sector patient cohort. Methods: Private sector costs were determined using de-identified claim-based data for all newly diagnosed CRC patients between 2012 and 2014. The costs obtained from this patient cohort were compared to previously published public sector data for the same period. The costs compared were costs incurred by the relevant sector funder and didn't include out-of-pocket costs. Results: The comparison shows private sector patients gain access to more of the approved regimens (12 vs. 4) but the same regimens are more costly, for example CAPOX costs approximately €150 more per cycle. The cost difference between 5FU and capecitabine monotherapy is less than €30 per cycle however, irinotecan is cheaper in comparison to oxaliplatin in the private sector (FOLFOX approx. €500 vs. FOLFIRI aprox. €460). Administrative costs account for up to 45% of total costs compared to the previously published data of these costs totaling < 15% of the full treatment cost in South Africa's public healthcare system. Conclusion: This comparison highlights the disparities between sectors while illustrating the need for further research to improve resource management to attain equitable healthcare.

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Section: Discussionsupporting

confidence: 90%

Colorectal Cancer (CRC) treatment and associated costs in the public sector compared to the private sector in Johannesburg, South Africa

Herbst

Miot

Moch

et al. 2020

BMC Health Serv Res

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“…The study of real-world direct health care costs in mCRC patients in the United States showed that the average cost of cancer regimen per month was USD 13,646 if bevacizumab in the first line and cetuximab in the second line had been administered, which presented 60% of the total costs. Similarly, the average cost per month was USD 12,773 if bevacizumab in the first line and panitumumab in the second line had been used [18]. However, direct costs in the Czech Republic and USA are not comparable due to different socioeconomic status and distinctions in a way of reimbursement of health care.…”

Section: Costs Of Mcrc Treatmentmentioning

confidence: 99%

THE REAL-WORLD COST AND EFFECTIVENESS STUDY OF TREATING mCRC WITH BEVACIZUMAB FOLLOWED BY CETUXIMAB OR PANITUMUMAB IN WT KRAS PATIENTS

Sehnalová¹

2020

FARMACIA

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Targeted monoclonal antibodies bevacizumab, cetuximab and panitumumab are reimbursed in the Czech Republic in combination with chemotherapy or alone in metastatic colorectal cancer (mCRC). However, the high cost is a potentially limiting factor. The real-world costs and effectiveness of first line bevacizumab followed by cetuximab or panitumumab (EGFRi) were retrospectively assessed from the perspective of healthcare payer. Total 71 WT KRAS patients (56% men; median age 60.5 years) were evaluated between April 2007 and May 2017. During our follow-up period (30 months on average) 55% patients died. The mean cost to PD was EUR 32,107 and EUR 24,510 in bevacizumab and EGFRi treatment respectively with median PFS 9.7 and 5.0 months. The median overall survival was 27.2 months and the mean cost from sequential therapy initiation to death was EUR 63,682. The targeted therapy made up 77%, 86% and 76% of the costs in the first line, second line and from the initiation of sequential therapy to death respectively. RezumatAnticorpii monoclonali bevacizumab, cetuximab și panitumumab sunt rambursați în Republica Cehă atât în monoterapie sau în combinație chimioterapice. Cu toate acestea, costul ridicat este un factor potențial limitativ. Costurile reale și eficacitatea bevacizumab, cetuximab și panitumumab (EGFRi) au fost evaluate în mod retrospectiv din perspectiva plătitorului de servicii medicale. 71 de pacienți KRAS KTT (56% bărbați; vârsta medie 60,5 ani) au fost evaluați în perioada aprilie 2007mai 2017. În perioada de urmărire (în medie 30 de luni), 55% dintre pacienți au murit. Costul mediu pentru progresia bolii a fost de 32.107 EUR și de 24.510 EUR în tratamentul cu bevacizumab și, respectiv, cu EGFRi. Supraviețuirea mediană totală a fost de 27,2 luni, iar costul mediu de la inițierea terapiei secvențiale până la deces a fost de 63.682 EUR. Terapia vizată a constituit 77%, 86% și 76% din costurile aferente primei linii, celei de-a doua și respectiv de la inițierea terapiei secvențiale până la deces.

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“…Isoprenoids are lipid compounds found in nature and they have many important functions (8,9). The enzymes that synthesize and use isoprenoids are among the most important drug targets for the treatment of cardiovascular disease, osteoporosis and bone metastases and have shown promise as antimicrobials (10)(11)(12). The five carbon (C5) precursors of isoprenoids, isopentenyl diphosphate (IPP) and dimethylallyl diphosphate (DMAPP) (Fig.…”

Section: Introductionmentioning

confidence: 99%

The heptaprenyl diphosphate synthase (Coq1) is the target of a lipophilic bisphosphonate that protects mice against Toxoplasma gondii infection

Sleda

Behera

et al. 2022

Preprint

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Prenyldiphosphate synthases catalyze the reaction of allylic diphosphates with one or more isopentenyl diphosphate molecules to form compounds such as farnesyl diphosphate, used in e.g. sterol biosynthesis and protein prenylation, as well as longer “polyprenyl” diphosphates, used in ubiquinone and menaquinone biosynthesis. Quinones play an essential role in electron transport and are associated with the inner mitochondrial membrane due to the presence of the polyprenyl group. In this work, we investigated the synthesis of the polyprenyl diphosphate that alkylates the ubiquinone ring precursor in Toxoplasma gondii, an opportunistic pathogen that causes serious disease in immunocompromised patients and the unborn fetus. The enzyme that catalyzes this early step of the ubiquinone synthesis is Coq1 (TgCoq1), and we show that it produces the C35 species, heptaprenyl diphosphate. TgCoq1 localizes to the mitochondrion, and is essential for in vitro T. gondii growth. We demonstrate that the growth defect of a T. gondii TgCoq1 mutant is rescued by complementation with a homologous TgCoq1 gene or with a (C45) solanesyl diphosphate synthase from Trypanosoma cruzi (TcSPPS). We find that a lipophilic bisphosphonate (BPH-1218) inhibits T. gondii growth at low nM concentrations, while overexpression of the TgCoq1 enzyme dramatically reduced growth inhibition by the bisphosphonate. Both the severe growth defect of the mutant and the inhibition by BPH-1218 were rescued by supplementation with a long chain (C30) ubiquinone (UQ6). Importantly, BPH-1218 also protected mice against a lethal T. gondii infection. TgCoq1 thus represents a potential drug target that could be exploited for improved chemotherapy of toxoplasmosis.ImportanceMillions of people are infected with Toxoplasma gondii and the available treatment for toxoplasmosis is not ideal. Most of the drugs currently used are only effective for the acute infection and treatment can trigger serious side-effects requiring changes in the therapeutic approach. There is, therefore, a compelling need for safe and effective treatments for toxoplasmosis. In this work, we characterize an enzyme of the mitochondrion of T. gondii that can be inhibited by an isoprenoid pathway inhibitor. We present several evidences that demonstrate that inhibition of the enzyme is linked to parasite death. In addition, the drug is able to protect mice against a lethal dose of T. gondii. Our results thus reveal a promising chemotherapeutic target for the development of new medicines for toxoplasmosis.

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Real-world Direct Health Care Costs for Metastatic Colorectal Cancer Patients Treated With Cetuximab or Bevacizumab-containing Regimens in First-line or First-line Through Second-line Therapy

Cited by 11 publications

References 5 publications

Colorectal Cancer (CRC) treatment and associated costs in the public sector compared to the private sector in Johannesburg, South Africa

Colorectal Cancer (CRC) treatment and associated costs in the public sector compared to the private sector in Johannesburg, South Africa

THE REAL-WORLD COST AND EFFECTIVENESS STUDY OF TREATING mCRC WITH BEVACIZUMAB FOLLOWED BY CETUXIMAB OR PANITUMUMAB IN WT KRAS PATIENTS

The heptaprenyl diphosphate synthase (Coq1) is the target of a lipophilic bisphosphonate that protects mice against Toxoplasma gondii infection

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