Cost-Effectiveness Analysis of Different Sequences of the Use of Epidermal Growth Factor Receptor Inhibitors for Wild-Type KRAS Unresectable Metastatic Colorectal Cancer

Abstract

First-line use of EGFRI in metastatic colorectal cancer is not cost effective at its current pricing relative to Bev.

Cost-Effectiveness of Nivolumab in Recurrent Metastatic Head and Neck Squamous Cell Carcinoma

“…For each adverse event, a utility deduction was assessed. The utility deductions were based on published Canadian and U.S. studies of chemotherapy‐associated adverse events . The values were calculated as the difference in EQ‐5D scores before the adverse event and after the adverse event as reported in the literature.…”

Colon Cancer, Version 1.2017, NCCN Clinical Practice Guidelines in Oncology

“…195 Economic analyses suggest that bevacizumab may be more cost-effective than EGFR inhibitors in first-line therapy for metastatic CRC. 196,197 At this time, the panel considers the addition of cetuximab, panitumumab, or bevacizumab to chemotherapy as equivalent choices in the first-line, RAS wild-type, metastatic setting.…”

Immunotherapy for Head and Neck Cancer in the Era of Exponentially Increasing Health Care Expenditure

“…Alternatively, proponents of estimates obtained from the general public or medical providers cite a potentially less biased valuation. Zargar et al obtained these utility weights from published Canadian and U.S. studies of adverse events associated with systemic cytotoxic therapy, most of which were generated by surveys of medical oncologists treating various malignancies . An example of how these utility weights may not accurately reflect the two treatments’ impact on health is hyperthyroidism.…”

“…Because there is no utility value for hyperthyroidism, the authors assigned fatigue as the utility weight, with the rationale that this is hypothyroidism's most common clinical presenting symptom. The utility weight for fatigue was obtained using a survey of gastrointestinal (GI) medical oncologists treating metastatic colorectal cancer . Although fatigue can also be observed in patients receiving immune checkpoint inhibitors, the degree to which it can be used as a surrogate for hyperthyroidism is questionable at best and unlikely to be comparable with the fatigue observed during cytotoxic chemotherapy for GI malignancies.…”