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Clinical and cost effectiveness of bevacizumab + FOLFIRI combination versus FOLFIRI alone as first-line treatment of metastatic colorectal cancer in South Korea.

Authors
 Eui-Kyung Lee  ;  Cedric Revil  ;  Charles A. Ngoh  ;  Johanna Lister  ;  Jeong-Mi Kwon  ;  Mee-Hye Park  ;  Seok-Jin Park  ;  Young-Suk Park  ;  Sang-Joon Shin  ;  Myung-Ah Lee  ;  Nam-Su Le  ;  Dae Young Zang  ;  Eun-Jin Bae  ;  Mi-Jeong Kang 
Citation
 Clinical Therapeutics, Vol.34(6) : 1408-1419, 2012 
Journal Title
 Clinical Therapeutics 
ISSN
 0149-2918 
Issue Date
2012
Abstract
BACKGROUND: Bevacizumab has been extensively investigated in combination with various standard chemotherapies in the treatment of metastatic colorectal cancer (mCRC). However, a comparison to irinotecan + infusional 5-fluorouracil/leucovorin (FOLFIRI) is lacking. OBJECTIVE: To explore clinical effectiveness and cost-effectiveness of adding bevacizumab to a regimen of FOLFIRI for the first-line treatment of mCRC in the Republic of Korea by conducting an indirect treatment comparison. METHODS: A health-economic model was developed to investigate the possible health outcomes (life-years gained [LYG]), direct costs, and incremental cost-effectiveness ratio (ICER) of adding bevacizumab to a FOLFIRI regimen. Data on progression-free and overall survival were derived from randomized clinical trials and were used in the indirect treatment comparison. The annual discount rate for costs and outcomes was 5%. A lifetime horizon of 8 years was used. Sensitivity analyses were carried out on all pivotal model assumptions. RESULTS: Incremental mean overall survival among patients treated with bevacizumab + FOLFIRI varied between 8.6 and 15.7 months compared with patients treated with FOLFIRI alone. The deterministic base-case result was 1.177 LYG. The discounted ICERs ranged from μ31.8 to μ39.5 million/LYG, with the base-case result being μ34.5 million/LYG. Treatment effect had the most impact on the outcomes in this model. CONCLUSIONS: Although there is no formal threshold for ICER per LYG in Korea, funding may be considered for bevacizumab + FOLFIRI, particularly if the severity and end-of-life nature of mCRC is taken into account.
Full Text
http://www.sciencedirect.com/science/article/pii/S0149291812003190
DOI
10.1016/j.clinthera.2012.05.001
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
신상준(Shin, Sang Joon) ORCID logo https://orcid.org/0000-0001-5350-7241
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90050
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