Abstract:
OBJECTIVE:To assess the cost-effectiveness of panitumumab in combination with mFOLFOX6 (oxaliplatin, 5-fluorouracil, and leucovorin) vs bevacizumab in combination with mFOLFOX6 as first-line treatment of patients with wild-type RAS metastatic colorectal cancer (mCRC) in Spain. METHODS:A semi-Markov model was developed including the following health states: Progression free; Progressive disease: Treat with best supportive care; Progressive disease: Treat with subsequent active therapy; Attempted resection of metastases; Disease free after metastases resection; Progressive disease: after resection and relapse; and Death. Parametric survival analyses of patient-level progression free survival and overall survival data from the PEAK Phase II clinical trial were used to estimate health state transitions. Additional data from the PEAK trial were considered for the dose and duration of therapy, the use of subsequent therapy, the occurrence of adverse events, and the incidence and probability of time to metastasis resection. Utility weightings were calculated from patient-level data from panitumumab trials evaluating first-, second-, and third-line treatments. The study was performed from the Spanish National Health System (NHS) perspective including only direct costs. A life-time horizon was applied. Probabilistic sensitivity analyses and scenario sensitivity analyses were performed to assess the robustness of the model. RESULTS:Based on the PEAK trial, which demonstrated greater efficacy of panitumumab vs bevacizumab, both in combination with mFOLFOX6 first-line in wild-type RAS mCRC patients, the estimated incremental cost per life-year gained was €16,567 and the estimated incremental cost per quality-adjusted life year gained was €22,794. The sensitivity analyses showed the model was robust to alternative parameters and assumptions. LIMITATIONS:The analysis was based on a simulation model and, therefore, the results should be interpreted cautiously. CONCLUSIONS:Based on the PEAK Phase II clinical trial and taking into account Spanish costs, the results of the analysis showed that first-line treatment of mCRC with panitumumab + mFOLFOX6 could be considered a cost-effective option compared with bevacizumab + mFOLFOX6 for the Spanish NHS.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Rivera F,Valladares M,Gea S,López-Martínez Ndoi
10.1080/13696998.2017.1285780subject
Has Abstractpub_date
2017-06-01 00:00:00pages
574-584issue
6eissn
1369-6998issn
1941-837Xjournal_volume
20pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:The objective of the current study was to propose an alternative method for measuring individual operator and peer volumes to use as predictors for adverse outcomes. STUDY DESIGN:A retrospective analysis was performed to assess the volume-outcome relationship for percutaneous coronary intervention (PCI) perf...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696990701815578
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abstract:OBJECTIVES:To describe treatment patterns and healthcare burden among individuals with suspected pulmonary arterial hypertension (PAH), as identified through a practice guideline-based healthcare claims algorithm. METHODS:Adults with evidence of PAH from 1 January 2004 (commercial and Medicaid) or 1 July 2006 (Medicar...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.690801
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abstract:OBJECTIVE:To construct a value-based healthcare system for rural Chinese hypertensive patients through an increasing outpatient care reimbursement ratio. METHODS:This comparative study sampled two similar counties, Dangyang County and Zhijiang County, in Hubei Province of China, as the intervention group and the contr...
journal_title:Journal of medical economics
pub_type: 杂志文章
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journal_title:Journal of medical economics
pub_type: 杂志文章
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journal_title:Journal of medical economics
pub_type: 杂志文章
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abstract::Background: Procedural efficiencies can contribute to cost reductions in transcatheter aortic valve replacement procedures (TAVR). The objective of this study is to determine operating room (OR) variable cost per minute in endovascular TAVR procedures, in a real-world hospital setting. Methods: Using Premier data from...
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doi:10.1080/13696998.2019.1588125
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doi:10.3111/13696998.2012.673525
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3111/13696998.2013.768999
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journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
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更新日期:2009-01-01 00:00:00