Cost-effectiveness of capecitabine and bevacizumab maintenance treatment after first-line induction treatment in metastatic colorectal cancer

被引：22

作者：

Franken, M. D. ^{[1
]}

van Rooijen, E. M. ^{[2
,12
]}

May, A. M. ^{[3
]}

Koffijberg, H. ^{[3
,4
]}

van Tinteren, H. ^{[5
]}

Mol, L. ^{[6
]}

ten Tije, A. J. ^{[7
]}

Creemers, G. J. ^{[8
]}

van der Velden, A. M. T. ^{[9
]}

Tanis, B. C. ^{[10
]}

Groot, C. A. Uyl-de ^{[2
]}

Punt, C. J. A. ^{[11
]}

Koopman, M. ^{[1
]}

van Oijen, M. G. H. ^{[11
]}

机构：

[1] Univ Med Ctr Utrecht, Dept Med Oncol, POB 85500, NL-3508 GA Utrecht, Netherlands

[2] Erasmus Univ, Inst Hlth Policy & Management, Inst Med Technol Assessment, POB 1738, NL-3000 DR Rotterdam, Netherlands

[3] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, POB 85500, NL-3508 GA Utrecht, Netherlands

[4] Univ Twente, Dept Hlth Technol & Serv Res, MIRA Inst Biomed Technol & Tech Med, POB 217, NL-7500 AE Enschede, Netherlands

[5] Netherlands Canc Inst, Dept Biostat, POB 90203, NL-1006 BE Amsterdam, Netherlands

[6] Netherlands Comprehens Canc Org, POB 1281, NL-6501 BG Nijmegen, Netherlands

[7] Amphia Hosp, Dept Med Oncol, POB 90158, NL-4800 RK Breda, Netherlands

[8] Catharina Hosp, Dept Med Oncol, POB 1350, NL-5602 ZA Eindhoven, Netherlands

[9] Tergooi Hosp, Dept Med Oncol, POB 10016, NL-1201 DA Hilversum, Netherlands

[10] Groene Hart Hosp, Dept Med Oncol, POB 1098, NL-2800 BB Gouda, Netherlands

[11] Univ Amsterdam, Dept Med Oncol, Acad Med Ctr, POB 22660, NL-1100 DD Amsterdam, Netherlands

[12] Novartis BV, Raapopseweg 1, NL-6824 DP Arnhem, Netherlands

来源：

EUROPEAN JOURNAL OF CANCER | 2017年 / 75卷

关键词：

Colorectal; Cancer; Cost-effectiveness; Capecitabine; Bevacizumab; QUALITY-OF-LIFE; PLUS BEVACIZUMAB; HEALTH; CHEMOTHERAPY; THERAPY; PANITUMUMAB; TRIAL; XELOX; 1ST; RECOMMENDATIONS;

D O I：

10.1016/j.ejca.2017.01.019

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aim: Capecitabine and bevacizumab (CAP-B) maintenance therapy has shown to be more effective compared with observation in metastatic colorectal cancer patients achieving stable disease or better after six cycles of first-line capecitabine, oxaliplatin, bevacizumab treatment in terms of progression-free survival. We evaluated the cost-effectiveness of CAP-B maintenance treatment. Methods: Decision analysis with Markov modelling to evaluate the cost-effectiveness of CAP-B maintenance compared with observation was performed based on CAIRO3 study results (n = 558). An additional analysis was performed in patients with complete or partial response. The primary outcomes were the incremental cost-effectiveness ratio (ICER) defined as the additional cost per life year (LY) and quality-adjusted life years (QALY) gained, calculated from EQ-5D questionnaires and literature and LYs gained. Univariable sensitivity analysis was performed to assess the influence of input parameters on the ICER, and a probabilistic sensitivity analysis represents uncertainty in model parameters. Results: CAP-B maintenance compared with observation resulted in 0.21 QALYs (0.18LYs) gained at a mean cost increase of 36,845, yielding an ICER of (sic)175,452 per QALY ( 204,694 per LY). Varying the difference in health-related quality of life between CAP-B maintenance and observation influenced the ICER most. For patients achieving complete or partial response on capecitabine, oxaliplatin, bevacizumab induction treatment, an ICER of 149,300 per QALY was calculated. Conclusion: CAP-B maintenance results in improved health outcomes measured in QALYs and LYs compared with observation, but also in a relevant increase in costs. Despite the fact that there is no consensus on cost-effectiveness thresholds in cancer treatment, CAP-B maintenance may not be considered cost-effective. (C) 2017 Elsevier Ltd. All rights reserved.

引用

页码：204 / 212

页数：9

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