Περίληψη:
Aim: To evaluate the cost-effectiveness of trifluridine and tipiracil
hydrochloride (FTD/TPI) compared with best supportive care (BSC) or
regorafenib for the treatment of patients with metastatic colorectal
cancer who have been previously treated with or are not considered
candidates for available therapies including fluoropyrimidine-,
oxaliplatin- and irinotecan-based chemotherapies, anti-VEGF agents and
anti-EGFR agents in Greece. Methods: A partitioned survival model was
locally adapted from a third-party payer perspective over a 10 year time
horizon. Efficacy data and utility values were extracted from published
studies. Resource consumption data were obtained from local experts
using a questionnaire developed for the purpose of the study and was
combined with unit costs obtained from official sources. All costs
reflect the year 2017 in euros. Primary outcomes were patients' life
years (LYs), quality-adjusted life years (QALYs), total costs and
incremental cost-effectiveness ratios (ICERs) per QALY and LYs gained.
Results: Total life time cost per patient for FTD/TPI, BSC and
regorafenib was estimated to be Euro10,087, Euro1,879 and Euro10,850,
respectively. In terms of health outcomes, FTD/TPI was associated with
0.25 and 0.11 increment in LYs compared with BSC and regorafenib,
respectively. Furthermore, FTD/TPI was associated with 0.17, and 0.07
increment in QALYs compared with BSC and regorafenib, resulting in ICERs
of Euro32,759 per LY gained and Euro49,326 per QALY gained versus BSC.
Moreover, FTD/TPI was a dominant alternative over regorafenib.
Conclusion: The results indicate that FTD/TPI may represent a
cost-effective treatment option compared with other alternative
therapies as a third-line treatment of metastatic colorectal cancer in
Greece.
Συγγραφείς:
Gourzoulidis, George
Maniadakis, Nikos
Petrakis, Dimitrios and
Souglakos, John
Pentheroudakis, George
Kourlaba, Georgia