Clinical and cost effectiveness of bevacizumab + FOLFIRI combination versus FOLFIRI alone as first-line treatment of metastatic colorectal cancer in South Korea
| Autor: | Myung Ah Lee, Young Suk Park, Sang Joon Shin, Seok Jin Park, Johanna Lister, Eui Kyung Lee, Charles Ngoh, Dae Young Zang, Cedric Revil, Nam Su Lee, Eun Jin Bae, Jeong Mi Kwon, Mi Jeong Kang, Mee Hye Park |
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| Rok vydání: | 2011 |
| Předmět: |
Oncology
medicine.medical_specialty Bevacizumab Cost effectiveness Cost-Benefit Analysis Leucovorin Antibodies Monoclonal Humanized law.invention Indirect costs Randomized controlled trial law Internal medicine Antineoplastic Combined Chemotherapy Protocols Republic of Korea medicine FOLFIRI Regimen Humans Pharmacology (medical) Neoplasm Metastasis health care economics and organizations Pharmacology business.industry Surgery Irinotecan Regimen FOLFIRI Camptothecin Fluorouracil business Colorectal Neoplasms medicine.drug |
| Zdroj: | Clinical therapeutics. 34(6) |
| ISSN: | 1879-114X |
| Popis: | Background Bevacizumab has been extensively investigated in combination with various standard chemotherapies in the treatment of metastatic colorectal cancer (mCRC). However, a comparison to irinotecan + infusional 5-fluorouracil/leucovorin (FOLFIRI) is lacking. Objective To explore clinical effectiveness and cost-effectiveness of adding bevacizumab to a regimen of FOLFIRI for the first-line treatment of mCRC in the Republic of Korea by conducting an indirect treatment comparison. Methods A health-economic model was developed to investigate the possible health outcomes (life-years gained [LYG]), direct costs, and incremental cost-effectiveness ratio (ICER) of adding bevacizumab to a FOLFIRI regimen. Data on progression-free and overall survival were derived from randomized clinical trials and were used in the indirect treatment comparison. The annual discount rate for costs and outcomes was 5%. A lifetime horizon of 8 years was used. Sensitivity analyses were carried out on all pivotal model assumptions. Results Incremental mean overall survival among patients treated with bevacizumab + FOLFIRI varied between 8.6 and 15.7 months compared with patients treated with FOLFIRI alone. The deterministic base-case result was 1.177 LYG. The discounted ICERs ranged from μ31.8 to μ39.5 million/LYG, with the base-case result being μ34.5 million/LYG. Treatment effect had the most impact on the outcomes in this model. Conclusions Although there is no formal threshold for ICER per LYG in Korea, funding may be considered for bevacizumab + FOLFIRI, particularly if the severity and end-of-life nature of mCRC is taken into account. |
| Databáze: | OpenAIRE |
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