Preview

FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology

Advanced search

Pharmacoeconomic evaluation of the effectiveness of therapy for metastatic colorectal cancer

https://doi.org/10.17749/2070-4909/farmakoekonomika.2021.081

Full Text:

Abstract

Objective: to perform a pharmacoeconomic evaluation of the effectiveness of therapies for metastatic colorectal cancer (mCRC) based on real practical data on medical help for patients with this disease.

Material and methods. The authors performed a comparative cost-effectiveness analysis and the calculation of resource consumption in the application of several options of chemotherapy for mCRC: FOLFOX, FOLFIRI, and FOLFOXIRI; targeted therapy: FOLFOX + bevacizumab, FOLFOX + panitumumab, FOLFIRI + cetuximab, FOLFIRI + aflibercept, regorafenib monotherapy.

Results. The cost-effectiveness parameter, calculated as a ratio of the cost of therapy to the median survival without progression, for chemotherapeutic schemes varied from 108 to 167 thousand rubles and for the targeted therapy schemes – from 223 to 930 thousand rubles. The calculation of resource consumption showed that in the case of a limited budget, 100% of patients can be treated by FOLFOX scheme, or 26% of patients by FOLFOX + panitumumab, or 47% of patients by FOLFOX + bevacizumab; and 100% of patients by FOLFIRI scheme or 11.5% of patients by FOLFIRI + cetuximab (aflibercept). Besides, it was established that in the case of a similar budget, 100% of patients with mCRC can be treated by chemotherapy schemes or a limited number of patients with regorafenib.

Conclusion. The cost of targeted therapy significantly exceeds the cost of chemotherapeutic schemes. Still, considering the gross domestic product per capita in the Russian Federation, they can be an economically feasible investment and the optimum option of therapy

About the Authors

Yu. Yu. Petukhova
Pacific State Medical University; Primorsky Regional Oncological Dispensary
Russian Federation

Yulia Yu. Petukhova – Postgraduate; Deputy Chief Physician for Medical Work

RSCI SPIN-code: 5379-3576

2 Ostryakov Ave., Primorsky Krai, Vladivostok 690000, Russia

59 Russkaya Str., Primorsky Krai, Vladivostok 690105, Russia



E. V. Eliseeva
Pacific State Medical University
Russian Federation

Ekaterina V. Eliseeva – Dr. Med. Sc., Professor, Chief of Chair of General and Clinical Pharmacology, Vice-Rector

RSCI SPIN-code: 1332-1667

2 Ostryakov Ave., Primorsky Krai, Vladivostok 690000, Russia



M. V. Volkov
Primorsky Regional Oncological Dispensary
Russian Federation

Михаил V. Volkov – MD, PhD, Chief Physician

RSCI SPIN-code: 3543-5183

59 Russkaya Str., Primorsky Krai, Vladivostok 690105, Russia



O. N. Li
Pacific State Medical University
Russian Federation

Olga N. Li – Dr. Med. Sc., Professor, Chair of General and Clinical Pharmacology

RSCI SPIN-code: 3543-5183

2 Ostryakov Ave., Primorsky Krai, Vladivostok 690000, Russia



A. G. Petukhova
Pacific State Medical University
Russian Federation

Antonina G. Petukhova – Student

2 Ostryakov Ave., Primorsky Krai, Vladivostok 690000, Russia



References

1. World Health Organization. Cancer. Available at: https://www.who.int/news-room/fact-sheets/detail/cancer (accessed 19.02.2021).

2. International Agency for Research on Cancer (WHO). Available at: www.iarc.fr (accessed 19.02.2021).

3. Global cancer observatory. Available at: https://gco.iarc.fr/ (accessed 19.02.2021).

4. Andreev D.A., Polyakova K.I., Zavyalov A.A., et al. Crucial areas of the economic analysis of public cancer care. FARMAKOEKONOMIKA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FAR MAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmaco epidemiology. 2019; 12 (4): 310–7 (in Russ.). https://doi.org/10.17749/2070-4909.2019.12.4.310-317.

5. Passport of the federal project “Fight against oncological diseases”, 2018. Available at: http://zdrav.tmbreg.ru/assets/files/Gosprogramm/nacionalnyy-proekt-zdravoohranenie/pasporta-fp/пфп-борьба-с-онкологичесиким-заболеваниями-14.12.2018.pdf (accessed 19.02.2021).

6. Kaprin A.D., Starinskiy V.V., Shakhzadova A.O. (Eds.) The State of cancer care in Russia in 2019. Moscow; 2020 (in Russ.).

7. Omelyanovskiy V.V., Avxentyeva M.V., Sura M.V., et al. Approaches to the creation of a unified method of calculation of incremental cost effectiveness ratio for the re-consideration of lists of medical drugs; an example of antineoplastic drugs. Medical Technologies. Assessment and Choice. 2018; 1: 10–20 (in Russ.).

8. Resolution of the Government of the Russian Federation of 28.08.2014 No. 871 (ed. of 12.06.2017) “On approval of the Rules for the formation of lists of medicines for medical use and the minimum range of medicines required for the provision of medical care”. Available at: http://www.consultant.ru/document/cons_doc_LAW_167999/ (in Russ.) (accessed 19.02.2021).

9. Draft Resolution of the Government of the Russian Federation “On Amendments to the Rules for the formation of lists of medicines for medical use and the minimum range of medicines required for the provision of medical care” Available at: https://www.garant.ru/products/ipo/prime/doc/56736744/ (in Russ.) (accessed 19.02.2021).

10. Zadlo J. Cost-effectiveness of new and emerging treatment options for metastatic colorectal cancer. Am J Manag Care. 2018; 24 (7 Suppl.): S118–24.

11. Sherman S.K., Lange J.J., Dahdaleh F.S., et al. Cost-effectiveness of maintenance capecitabine and bevacizumab in metastatic colorectal cancer. JAMA Oncol. 2019; 5 (2): 236–42. https://doi.org/10.1001/jamaoncol.2018.5070.

12. Tryakin A.A., Balunov P.A. Pharmacoeconomic evaluation of the use of targeted therapy and chemotherapy in the first- and second line therapies for metastatic colorectal cancer. Medical Council. 2018; 19: 50–5 (in Russ.). https://doi.org/10.21518/2079-701X-2018-19-50-55.

13. Fedyanin M.Yu., Tryakin A.A., Rogov V.A., et al. Pharmacoeconomic guided choice of systemic chemotherapy in metastatic colorectal cancer patients. Pelvic Surgery and Oncology. 2017; 7 (2): 36–42 (in Russ.). https://doi.org/10.17650/2220-3478-2017-7-2-36-42.

14. Douillard J.Y., Siena S., Cassidy J., et al. Final results from PRIME: randomized phase III study of panitumumab with FOLFOX4 for first-line treatment of metastatic colorectal cancer. Ann Oncol. 2014; 25 (7): 1346–55. https://doi.org/10.1093/annonc/mdu141.

15. Van Cutsem E., Köhne C.H., Hitre E., et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009; 360 (14): 1408–17. https://doi.org/10.1056/NEJMoa0805019.

16. Loupakis F., Yang D., Yau L., et al. Primary tumor location as a prognostic factor in metastatic colorectal cancer. J Natl Cancer Inst. 2015; 107 (3): dju427. https://doi.org/10.1093/jnci/dju427.

17. Van Cutsem E., Joulain F., Hoff P.M., et al. Aflibercept plus FOLFIRI vs. placebo plus FOLFIRI in second-line metastatic colorectal cancer: a post hoc analysis of survival from the phase III VELOUR study subsequent to exclusion of patients who had recurrence during or within 6 months of completing adjuvant oxaliplatin-based therapy. Target Oncol. 2016; 11 (3): 383–400. https://doi.org/10.1007/s11523-015-0402-9.

18. Cremolini C., Antoniotti C., Rossini D., et al. Upfront FOLFOXIRI plus bevacizumab and reintroduction after progression versus mFOLFOX6 plus bevacizumab followed by FOLFIRI plus bevacizumab in the treatment of patients with metastatic colorectal cancer (TRIBE2): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol. 2020; 21 (4): 497–507. https://doi.org/10.1016/S1470-2045(19)30862-9.

19. Grothey A., Van Cutsem E., Sobrero A., et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo controlled, phase 3 trial. Lancet. 2013; 381 (9863): 303–12. https://doi.org/10.1016/S0140-6736(12)61900-X.

20. Li J., Qin S., Xu R., et al. Regorafenib plus best supportive care versus placebo plus best supportive care in Asian patients with previously treated metastatic colorectal cancer (CONCUR): a randomised, double blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2015; 16 (6): 619–29. https://doi.org/10.1016/S1470-2045(15)70156-7.

21. Clinical guidelines. Malignant neoplasms of the colon and rectosigmoid department. 2020. Available at: https://www.infomed39.ru/upload/iblock/f71/KR396-Zlokachestvennye-novoobrazovaniya-obodochnoy-kishki-i-rektosigmoidnogo-otdela.pdf (in Russ.) (accessed 19.02.2021).

22. Eliseeva E.V., Petukhova Yu.Yu., Petukhova A.G. Cost-effectiveness indicator for colorectal cancer therapy. Pacific Medical Journal. 2020; 4: 24–8 (in Russ.). https://doi.org/10.34215/1609-1175-2020-4-24-28.

23. Avxentyeva M.V., Gorkavenko F.V., Nikitina A.V., et al. Estimation of socioeconomic burden of lung cancer in the Russian Federation. Medical Technologies. Assessment and Choice. 2018; 4: 63–75 (in Russ.). https://doi.org/10.31556/2219-0678.2018.34.4.063-075.

24. Ignatyeva V.I., Gretsova O.P., Stenina M.B., et al. Social and economic burden of breast cancer in the Russian Federation. Medical Technologies. Assessment and Choice. 2016; 4: 32–49 (in Russ.).

25. Kontsevaya A.V., Balanova Yu.A., Myrzamatova A.O., et al. Economic losses due to oncologic diseases related to modifiable risk factors. Health Risk Analysis. 2020; 1: 133–41 (in Russ.). https://doi.org/10.21668/health.risk/2020.1.15.

26. Gorchakov S.V., Pravosudov I.V., Vasilyev S.V., et al. Long-term results and prognostic factors – their influence on the choice of treatment tactics for patients with colorectal cancer with liver metastases. Oncology Bulletin of the Volga Region. 2016; 1: 29–37 (in Russ.).

27. Dobrova N.V., Gordeeva O.O., Chernoglazova E.V., Tryakin A.A. Chemotherapy in the management of localized and metastatic colon cancer: new and yet unforgotten approaches. Medical Council. 2017; 14: 67–76 (in Russ.). https://doi.org/10.21518/2079-701X-2017-14-67-76.

28. Russia’s GDP by year: 1991–2021. Available at: http://globalfinances.ru/vvp-rossii-po-godam/ (accessed 19.02.2021).

29. Yagudina R.I., Kulikov A.Yu., Metelkin I.A. Methodology of cost effectiveness analysis in pharmacoeconomics. FARMAKOEKONOMIKA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FAR MAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmaco epidemiology. 2012; 5 (4): 3–8 (in Russ.).


For citation:


Petukhova Yu.Yu., Eliseeva E.V., Volkov M.V., Li O.N., Petukhova A.G. Pharmacoeconomic evaluation of the effectiveness of therapy for metastatic colorectal cancer. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2021;14(3):291-298. (In Russ.) https://doi.org/10.17749/2070-4909/farmakoekonomika.2021.081

Views: 75


ISSN 2070-4909 (Print)
ISSN 2070-4933 (Online)