IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0038557.html
   My bibliography  Save this article

Cost-Effectiveness of Adding Cetuximab to Platinum-Based Chemotherapy for First-Line Treatment of Recurrent or Metastatic Head and Neck Cancer

Author

Listed:
  • Malek B Hannouf
  • Chander Sehgal
  • Jeffrey Q Cao
  • Joseph D Mocanu
  • Eric Winquist
  • Gregory S Zaric

Abstract

Purpose: To assess the cost effectiveness of adding cetuximab to platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) from the perspective of the Canadian public healthcare system. Methods: We developed a Markov state transition model to project the lifetime clinical and economic consequences of recurrent or metastatic HNSCC. Transition probabilities were derived from a phase III trial of cetuximab in patients with recurrent or metastatic HNSCC. Cost estimates were obtained from London Health Sciences Centre and the Ontario Case Costing Initiative, and expressed in 2011 CAD. A three year time horizon was used. Future costs and health benefits were discounted at 5%. Results: In the base case, cetuximab plus platinum-based chemotherapy compared to platinum-based chemotherapy alone led to an increase of 0.093 QALY and an increase in cost of $36,000 per person, resulting in an incremental cost effectiveness ratio (ICER) of $386,000 per QALY gained. The cost effectiveness ratio was most sensitive to the cost per mg of cetuximab and the absolute risk of progression among patients receiving cetuximab. Conclusion: The addition of cetuximab to standard platinum-based chemotherapy in first-line treatment of patients with recurrent or metastatic HNSCC has an ICER that exceeds $100,000 per QALY gained. Cetuximab can only be economically attractive in this patient population if the cost of cetuximab is substantially reduced or if future research can identify predictive markers to select patients most likely to benefit from the addition of cetuximab to chemotherapy.

Suggested Citation

  • Malek B Hannouf & Chander Sehgal & Jeffrey Q Cao & Joseph D Mocanu & Eric Winquist & Gregory S Zaric, 2012. "Cost-Effectiveness of Adding Cetuximab to Platinum-Based Chemotherapy for First-Line Treatment of Recurrent or Metastatic Head and Neck Cancer," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-9, June.
    • Handle: RePEc:plo:pone00:0038557
    DOI: 10.1371/journal.pone.0038557
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0038557
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0038557&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0038557?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Claire McKenna & Karl Claxton, 2011. "Addressing Adoption and Research Design Decisions Simultaneously," Medical Decision Making, , vol. 31(6), pages 853-865, November.
    2. Frank A. Sonnenberg & J. Robert Beck, 1993. "Markov Models in Medical Decision Making," Medical Decision Making, , vol. 13(4), pages 322-338, December.
    3. Dennis G. Fryback & William F. Lawrence JR, 1997. "Dollars May Not Buy as Many QALYs as We Think:," Medical Decision Making, , vol. 17(3), pages 276-284, July.
    4. Ifigeneia Mavranezouli, 2010. "A Review and Critique of Studies Reporting Utility Values for Schizophrenia-Related Health States," PharmacoEconomics, Springer, vol. 28(12), pages 1109-1121, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Vincent T Janmaat & Marco J Bruno & Suzanne Polinder & Sylvie Lorenzen & Florian Lordick & Maikel P Peppelenbosch & Manon C W Spaander, 2016. "Cost-Effectiveness of Cetuximab for Advanced Esophageal Squamous Cell Carcinoma," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-10, April.
    2. Evgeni Dvortsin & Judith Gout-Zwart & Ernst-Lodewijk Marie Eijssen & Jan van Brussel & Maarten J Postma, 2016. "Comparative Cost-Effectiveness of Drugs in Early versus Late Stages of Cancer; Review of the Literature and a Case Study in Breast Cancer," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-12, January.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Heß, Michael (Ed.) & Schlieter, Hannes (Ed.), 2014. "Modellierung im Gesundheitswesen: Tagungsband des Workshops im Rahmen der Modellierung 2014," ICB Research Reports 57, University Duisburg-Essen, Institute for Computer Science and Business Information Systems (ICB).
    2. Zixian, Liu & Xin, Ni & Yiliu, Liu & Qinglu, Song & Yukun, Wang, 2011. "Gastric esophageal surgery risk analysis with a fault tree and Markov integrated model," Reliability Engineering and System Safety, Elsevier, vol. 96(12), pages 1591-1600.
    3. Pedram Sendi & Huldrych F Günthard & Mathew Simcock & Bruno Ledergerber & Jörg Schüpbach & Manuel Battegay & for the Swiss HIV Cohort Study, 2007. "Cost-Effectiveness of Genotypic Antiretroviral Resistance Testing in HIV-Infected Patients with Treatment Failure," PLOS ONE, Public Library of Science, vol. 2(1), pages 1-8, January.
    4. Karl Claxton & Elisabeth Fenwick & Mark J. Sculpher, 2012. "Decision-making with Uncertainty: The Value of Information," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 51, Edward Elgar Publishing.
    5. Bärnighausen, Till & Bloom, David E., 2009. ""Conditional scholarships" for HIV/AIDS health workers: Educating and retaining the workforce to provide antiretroviral treatment in sub-Saharan Africa," Social Science & Medicine, Elsevier, vol. 68(3), pages 544-551, February.
    6. Mattias Ekman & Peter Lindgren & Carolin Miltenburger & Genevieve Meier & Julie Locklear & Mary Chatterton, 2012. "Cost Effectiveness of Quetiapine in Patients with Acute Bipolar Depression and in Maintenance Treatment after an Acute Depressive Episode," PharmacoEconomics, Springer, vol. 30(6), pages 513-530, June.
    7. Ara, R & Brazier, JE, 2010. "Using health state utility values from the general population to approximate baselines in decision analytic models when condition specific data are not available," MPRA Paper 29946, University Library of Munich, Germany.
    8. Rowan Iskandar & Carlo Federici & Cassandra Berns & Carl Rudolf Blankart, 2022. "An approach to quantify parameter uncertainty in early assessment of novel health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 116-134, September.
    9. de Wit, G.Ardine & Ramsteijn, Paul G & de Charro, Frank Th, 1998. "Economic evaluation of end stage renal disease treatment," Health Policy, Elsevier, vol. 44(3), pages 215-232, June.
    10. Robert L. Herrick & Steven G. Buchberger & Robert M. Clark & Margaret Kupferle & Regan Murray & Paul Succop, 2012. "A Markov Model To Estimate Salmonella Morbidity, Mortality, Illness Duration, And Cost," Health Economics, John Wiley & Sons, Ltd., vol. 21(10), pages 1169-1182, October.
    11. Afschin Gandjour & Eva-Julia Weyler, 2006. "Cost-effectiveness of referrals to high-volume hospitals: An analysis based on a probabilistic Markov model for hip fracture surgeries," Health Care Management Science, Springer, vol. 9(4), pages 359-369, November.
    12. Malek Ebadi & Raha Akhavan-Tabatabaei, 2021. "Personalized Cotesting Policies for Cervical Cancer Screening: A POMDP Approach," Mathematics, MDPI, vol. 9(6), pages 1-20, March.
    13. Hiral Anil Shah & Tim Baker & Carl Otto Schell & August Kuwawenaruwa & Khamis Awadh & Karima Khalid & Angela Kairu & Vincent Were & Edwine Barasa & Peter Baker & Lorna Guinness, 2023. "Cost Effectiveness of Strategies for Caring for Critically Ill Patients with COVID-19 in Tanzania," PharmacoEconomics - Open, Springer, vol. 7(4), pages 537-552, July.
    14. Gabriel Rogers & Ruth Garside & Stuart Mealing & Martin Pitt & Rob Anderson & Matthew Dyer & Ken Stein & Margaret Somerville, 2008. "Carmustine Implants for the Treatment of Newly Diagnosed High-Grade Gliomas," PharmacoEconomics, Springer, vol. 26(1), pages 33-44, January.
    15. Bleichrodt, Han & Crainich, David & Eeckhoudt, Louis, 2003. "Comorbidities and the willingness to pay for health improvements," Journal of Public Economics, Elsevier, vol. 87(11), pages 2399-2406, October.
    16. Laura McCullagh & Cathal Walsh & Michael Barry, 2012. "Value-of-Information Analysis to Reduce Decision Uncertainty Associated with the Choice of Thromboprophylaxis after Total Hip Replacement in the Irish Healthcare Setting," PharmacoEconomics, Springer, vol. 30(10), pages 941-959, October.
    17. Mark Sculpher & David Torgerson & Ron Goeree & Bernie O'Brien, 1999. "A critical structured review of economic evaluations of interventions for the prevention and treatment of osteoporosis," Working Papers 169chedp, Centre for Health Economics, University of York.
    18. Hua Zhang & Mingdong Huo & Jianqian Chao & Pei Liu, 2016. "Application of Bayesian Approach to Cost-Effectiveness Analysis of Antiviral Treatments in Chronic Hepatitis B," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-9, August.
    19. F. Tomini & F. Prinzen & A. D. I. Asselt, 2016. "A review of economic evaluation models for cardiac resynchronization therapy with implantable cardioverter defibrillators in patients with heart failure," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1159-1172, December.
    20. repec:zbw:rwirep:0287 is not listed on IDEAS
    21. Alan Brennan & Stephen E. Chick & Ruth Davies, 2006. "A taxonomy of model structures for economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1295-1310, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0038557. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.