Objectives: To conduct a cost-effectiveness analysis of panitumumab plus mFOL-FOX6 versus bevacizumab plus mFOLFOX6 as first-line treatment (FLT) of metastatic colorectal cancer (mCRC) patients with wild-type RASin the Greek health care setting. MethOds: An existing Markov model consisting of seven health states was adapted from the public third-party-payer perspective. Both efficacy and safety data considered in the model were extracted from the PEAK trial and other published studies. Utility values were also extracted from the literature. Direct medical costs consisting of drug-acquisition costs for FLT, administration costs, subsequent therapy costs and other medical costs were incorporated into the model and reflect the year 2014. Primary outcomes were patient survival (life-years), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) per QALY gained. Probabilistic sensitivity analysis (PSA) was conducted to account for uncertainty and variation in the parameters of the model. Results: The analysis showed that panitumumab plus mFOLFOX6 produced greater discounted survival and quality adjusted survival by 0.87 LYs and 0.65 QALY benefit in relation to bevacizumab plus mFOLFOX6. The total lifetime cost was € 75,200 and € 52,736 for panitumumab and bevacizumab plus mFOLFOX6, respectively. This difference was mainly attributed to the higher acquisition cost of panitumumab compared to bevacizumab during the pre-progression health state (€ 32,223 and € 14,730 respectively). Incremental analysis showed that panitumumab plus mFOLFOX6 was more effective and more costly than bevacizumab plus mFOLFOX6 resulting in an ICER equal to € 34,644 per QALY gained. PSA revealed that the probability of panitumumab plus mFOL-FOX6 being cost-effective over bevacizumab plus mFOLFOX6 was 81.5% at the predetermined threshold of € 51,000 per QALY gained (3 times the GDP per capita of Greece). cOnclusiOns: The results suggest that panitumumab plus mFOLFOX6 may be a cost-effective alternative relative to bevacizumab plus mFOLFOX6 as FLT of mCRC patients with wild-type RASin Greece.
days/year that were previously lost due to migraine, resulting in a positive ROI of 510%. In addition to ROI and work productivity gained, participants also gained on average 13.6 migraine-free days/year for their private and social life. Conclusions: This analysis concludes that the migraine disease management program has a high ROI informing other employers that the systematic inclusion of migraine management into corporate health management programs can be of significant benefit to the impacted individuals as well as the companies.
and the total number of prescriptions increased from 9.4 million in 1991 to 36.1 million in 2018, an increase of 285.4%. The 1 st generation AEDs prescription number declined from 2004, whereas the 2 nd generation AEDs prescriptions rose from 8.9 million in 2004 to 26.7 million in 2018, which was 74.0% of the total AEDs prescription in 2018. The 3 rd generation AEDs accounted for only 2.6% of the total prescription for AEDs in 2018 but 44.
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