The cost-effectiveness and cost-utility analysis of adding Cetuximab to Platinum Based Chemotherapy for Treatment of Metastatic Head and Neck Cancer.

Publish Year: 1398
نوع سند: مقاله کنفرانسی
زبان: English
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شناسه ملی سند علمی:

AECPMED02_033

تاریخ نمایه سازی: 28 بهمن 1398

Abstract:

Introduction: This study was conducted to assess the cost-effectiveness of adding cetuximab to cisplatin and fluorouracil in the treatment of patients with recurrent head and neck carcinoma from the perspective of the Iranian public healthcare system. Methods: A systematicreview and consultation with clinicians on cetuximab add on therapy use, in HNSCC and its effect on transition probabilities, source of cost and quality of life has performed. Then, a time-varying probabilities for the transition of Markov model was developed by the implementation of Iranspecific features. The model begins with a decision to treat with cetuximab plus platinum-based chemotherapy (11 states) or platinum-based chemotherapy alone (3 states). Uncertain parameters are assigned probability distributions and analyses performed by Monte Carlo simulation. Future costs and health benefits were respectively discounted at 5% and 3%. Result: In the base case, cetuximab add‐on therapy led to an increase of 0.06 QALY and 519,651,755 Rial per person, resulting in an incremental cost-effectiveness ratio (ICER) of 828,128,259.91966 Rial per QALYgained. The cost-effectiveness ratio was most sensitive to the cost per mg of maintenance dose of cetuximab. Conclusion: Due to the Iranian Health Organization-recommended cost-effectiveness threshold Adding cetuximab to cisplatin and fluorouracil despite 0.06 QALY gain, cannot beconsidered cost-effective in patients with head and neck cancer in Iran.

Authors

mahyar polroudi moghaddam

shahid beheshti medical university

Niloofar foroughi Abari

Islamic Azad University Pharmaceutical Sciences Branch

javad shirmohammadi

shahid beheshti medical university

Farzad Peiravian

shahid beheshti medical university