Περίληψη:
Objectives Colorectal cancer (CRC) is the second leading cause of cancer
in Europe, with 1.931.590 people newly diagnosed in 2020. The purpose of
this study is the investigation of treatment options and healthcare
resource metastatic CRC (mCRC) in Greece. Methods This study is based on
the information collected in November 2020 by an expert panel comprising
of 6 medical oncologists from major public and private centers around
Greece. A 3-round survey was undertaken, according to Delphi method. The
treatment phases studied were: pre-progression; disease progression and
terminal care. Pharmaceutical costs and resource utilization data were
considered from the perspective of the Greek National Services
Organization (EOPYY). RESULTS: Experts agreed that the anticipated
prevalence of RAS mutation in mCRC is 47% (30% RAS/BRAF WT Left, 17%
RAS/BRAF WT Right); 8% BRAF while, MSI-H/dMMR are found in 5% of mCRC
tumors. Based on mutational status, 74.8% of patients receive
biological targeted therapies in combination with fluoropyrimidine/based
combination chemotherapy, as 1st line treatment, and 25.2% combination
chemotherapy alone. At 2nd line, 58.6% of patients receive biological
targeted therapies in combination with chemotherapy, 25.4%
immunotherapy, 11% combination chemotherapy and 5% biological targeted
therapies. At 3rd line 56% of patients receive combination
chemotherapy, 28% biological targeted therapies, 10% biological
targeted therapies in combination with chemotherapy and 6%
immunotherapy. The weighted annual cost (pharmaceuticals and resource
use cost) in 1st line per mCRC patient was calculated at euro28,407, in
2nd line euro33,568, in 3rd line euro25,550. The annual cost beyond 3rd
line per patient regardless mutation was euro19,501 per mCRC patient.
Conclusions mCRC is a societal challenge for healthcare systems as the
treatment is more prolonged but expand patients’ survival. Thus,
reimbursement decisions should be based not just on the cost of the
treatment, but on the magnitude of the benefit of its treatment on
patients’ survival and quality of life.
Συγγραφείς:
Sougklakos, Ioannis
Athanasiadis, Elias
Boukovinas, Ioannis and
Karamouzis, Michalis
Koutras, Aggelos
Papakotoulas, Paulos and
Latsou, Dimitra
Hatzikou, Magda
Stamuli, Eugena and
Balasopoulos, Athanasios
Sideris, Aggelos