RESEARCH ARTICLE


Cost Impact of Bevacizumab and Cetuximab Associated Therapies in Colorectal Cancer in Veneto Region



Simonetta Ballali1, Daniele Chiffi2, Marta P. Trojniak3, Dario Gregori*, 2, §
1 Prochild Onlus, Trieste, Italy & Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
2 Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
3 Oncology Pharmacy Department, Istituto Oncologico Veneto, IRCCS, Padova, Italy

Article Information


Identifiers and Pagination:

Year: 2013
Volume: 7
First Page: 9
Last Page: 16
Publisher Id: TOPHARMJ-7-9
DOI: 10.2174/1874143601307010009

Article History:

Received Date: 9/10/2012
Revision Received Date: 9/1/2013
Acceptance Date: 14/1/2013
Electronic publication date: 19/4/2013
Collection year: 2013

© 2013 Ballali;

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, Via Loredan 18, 35121 Padova, Italy.
§ EIHCD-VeRo (Economic Impact of High Cost Drugs in the Veneto Region) Research Project Agreement members: Dario Gregori (Principal Investigator), Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy; Daniele Chiffi, Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy; Francesco Grigoletto, Department of Environmental Medicine and Public Health, University of Padova, Italy; Egle Perissinotto, Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy; Alessandra Buja, Department of Molecular Medicine, University of Padova, Italy; Andrea Tramarina, Veneto Regional Health Agency, Italy; Costantino Gallo, Veneto Regional Health Agency, Italy; Antonio Compostella, Veneto Regional Health Agency, Italy; Davide Pastorelli, Istituto Oncologico del Veneto IRCSS, Padova, Italy; Giuseppe Rausa, Department of Environmental Medicine and Public Health, University of Padova, Italy.


Abstract

Objective:

To assess the economic impact of the introduction of bevacizumab and cetuximab, in 1st and 2nd line treatment of mCRC patients in Veneto region (North-East of Italy).

Methods:

A Markov state decision model was implemented to evaluate the cost impact of bevacizumab and cetuximab use in patients with mCRC for a lapse of time of three years in Veneto public hospitals. The Markov model expressed transition probabilities from three different states, comparing in addition the expected deaths and the monthly survival rates in treatment and no-treatment groups, along the lines of previously published studies.

Results:

The cost impact of bevacizumab administration in patients with mCRC accounted a mean value of 18268788€ within the first 6 months. Cetuximab therapy for those refractory to 1st line treatment, increased costs of almost 833340€ in the first 6 months, increasing in the following period due to a higher portion of patients switching from a stable status to a progressive one.

Discussion:

The cost impact of monoclonal antibodies on health expenses is very high. For a regional cohort like the Veneto’s one, figure sets around 19000000€ in 6 months, when considering 1 and 2 line treatment, reaching the level of 50000000€ within three years.

Keywords: Bevacizumab, cetuximab, cost, KRAS wild type, metastatic colorectal cancer, Veneto.