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HTA and Gastric Cancer: Evaluating Alternatives in Third- and Fourth-Line Patients

Author

Listed:
  • Lucrezia Ferrario

    (Centre for Health Economics, Social and Health Care Management, LIUC Business School, HD LAB—Healthcare Datascience, LAB LIUC University Carlo Cattaneo, 21053 Castellanza, Italy)

  • Federica Asperti

    (Centre for Health Economics, Social and Health Care Management, LIUC Business School, HD LAB—Healthcare Datascience, LAB LIUC University Carlo Cattaneo, 21053 Castellanza, Italy)

  • Giuseppe Aprile

    (Department of Oncology, ULSS 8 Berica Hospital, 36100 Vicenza, Italy)

  • Jacopo Giuliani

    (Department of Oncology, ULSS 9 Scaligera, Mater Salutis Hospital, 37045 Legnago, Italy)

Abstract

Metastatic gastric cancer (mGC) represents an economic and societal burden worldwide. The present study has two aims. Firstly, it evaluates the benefits and the added value of the introduction of trifluridine/tipiracil (FTD/TPI) in the Italian clinical practice, defining the comparative efficacy and safety profiles with respect to the other available treatment options (represented by the best supportive care (BSC) and FOLFIRI (5-FU, irinotecan, and leucovorin) regimens). Secondly, it assesses the potential economic and organizational advantages for hospitals and patients, focusing on third- and fourth-line treatments. For the achievement of the above objective, a health technology assessment study was conducted in 2021, assuming the NHS perspective within a 3-month time horizon. The literature reported a better efficacy of FTD/TPI with respect to both BSC and FOLFIRI regimens. From an economic perspective, despite the additional economic resources that would be required, the investment could positively impact the overall survival rate for the patients treated with the FTD/TPI strategy. However, the innovative molecule would lead to a decrease in hospital accesses devoted to chemotherapy infusion, ranging from a minimum of 34% to a maximum of 44%, strictly dependent on FTD/TPI penetration rate, with a consequent opportunity to take on a greater number of oncological patients requiring drug administration for the treatment of any other cancer diseases. According to experts’ opinions, lower perceptions of FTD/TPI emerged concerning equity aspects, whereas it would improve both individuals’ and caregivers’ quality of life. In conclusion, the results have demonstrated the strategic relevance related to the introduction of FTD/TPI regarding the coverage of an important unmet medical need of patients with metastatic gastric cancer who were refractory to at least two prior therapies, with important advantages for patients and hospitals, thus optimizing the clinical pathway of such frail patients.

Suggested Citation

  • Lucrezia Ferrario & Federica Asperti & Giuseppe Aprile & Jacopo Giuliani, 2023. "HTA and Gastric Cancer: Evaluating Alternatives in Third- and Fourth-Line Patients," IJERPH, MDPI, vol. 20(3), pages 1-14, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:2107-:d:1045357
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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