Cost analysis of cetuximab (Erbitux) plus radiotherapy (ERT) versus concomitant cisplatin plus radiotherapy (CRT) within an NHS oncology unit (single institution): a pilot study

Abstract

Cetuximab is still more expensive in simple drug cost terms than cisplatin when delivered with radiotherapy taking into account costs of drugs for toxicity management and nutritional supplements but other resource implications such as inpatient admission, time spent delivering unscheduled care and cost of additional investigations to manage toxicity for patients treated with cisplatin significantly reduce differential. The study suggested significant differences in patient-reported PEG use at 6 months and in time to PEG removal in favour of the cetuximab arm. Advances in knowledge: There is paucity of randomized data on cost analysis for cisplatin vs cetuximab radiotherapy; this trial informs on the cost analysis between the two approaches.

Concurrent cisplatin or cetuximab with radiotherapy in patients with locally advanced head and neck squamous cell carcinoma

“…Twenty-three studies with a total of 8701 patients were enrolled in this meta-analysis; and Table 1 summarizes the major characteristics of the enrolled studies. The eligible studies consisted of 18 retrospective trials [ 22 – 40 ] and 5 prospective studies, [ 11 , 12 , 41 – 43 ] including 2 randomized, multicenter, and phase 3 trials. [ 11 , 12 ] For the median age, patients treated with CRT were generally older than patients treated with BRT.…”

“…Moreover, heterogeneity might partly result from different administration and doses of cisplatin. Cisplatin was given at 40 mg/m 2 weekly in some studies, [ 25 , 28 , 35 , 41 , 42 ] while 100 mg/m 2 was administered every 3 weeks in others studies. The heterogeneity may be reduced after the standardization of the issues in the future.…”

Assessing Care Value for Older Patients Receiving Radiotherapy With or Without Cisplatin or Cetuximab for Locoregionally Advanced Head and Neck Cancer

“…Health care utilization of drugs like cetuximab is critical to address as we balance questions of treatment effectiveness with the limited resources in modern US health care . US data on cetuximab’s costs in head and neck cancer are scant, but a British study into the costs of care reported that cetuximab remains the more expensive option compared with cisplatin, even after taking into account the differences in percutaneous gastrostomy tube use and cost of additional care and interventions . The present results showed that the 3-month Medicare spending on patients receiving radiotherapy with cetuximab was higher in general compared with those receiving radiotherapy only or radiotherapy with cisplatin, largely owing to infusion services and chemotherapy spending.…”

“…Both the CMS Innovation Center Oncology Care Model and the CMS OP-35 (outpatient quality measures) include these metrics and encourage clinicians to designs systems and processes to avoid unplanned hospital-based care. Data from the United Kingdom suggest that differences in resource use exist between patients treated with radiotherapy with cetuximab and patients treated with radiotherapy with cisplatin, but evidence of health care utilization of the various treatment pathways in head and neck cancer care is lacking in the United States. Thus, in the treatment of stages III to IVB head and neck cancer in patients 65 years or older, assessment of the value of cetuximab is complex.…”

Inhaled Delivery of Cetuximab-Conjugated Immunoliposomes Loaded with Afatinib: A Promising Strategy for Enhanced Non-Small Cell Lung Cancer Treatment

“…Firstly, the preparation process of immunoliposomes is intricate and ensuring the stability of monoclonal antibodies in novel formulations presents di culties (Merino, Zalba, Garrido 2018). Secondly, antibody production costs are high and conventional dosages often necessitate large quantities(Bou-Assaly and Mukherji 2010; Caroline et al 2016). Thirdly, the ability of antibody-mediated liposome internalization can impact the penetration of the drug delivery system into target cells(van Elk et al 2016; Abu Lila and Ishida 2017).…”