Aflibercept in Combination with Folfiri in Patients with Metastatic Colorectal Cancer: Cost-Effectiveness Based on Velour Best Efficacy Subgroup Post-Hoc Analysis

  • Echave M
  • Oyagüez I
  • Lamas M
  • et al.
N/ACitations
Citations of this article
6Readers
Mendeley users who have this article in their library.

Abstract

Objectives: To estimate the incremental cost per life-year gained (LYG) of aflibercept in combination with FOLFIRI as second-line treatment in metastatic colorectal cancer (mCRC) in Best Efficacy Subgroup (BES) patients previously treated with oxaliplatino compared to FOLFIRI. Methods: A post-hoc analysis of the VELOUR clinical trial revealed an improvement of aflibercept efficacy in a specific subgroup. BES was composed by patients with performance status (PS) 0 with any number of metastatic sites or PS 1 with < 2 metastatic sites, exclusive of adjuvant fast relapsers. A Markov model with 3 health states (stable disease, progression and death) was used to estimate lifetime costs and outcomes (2-weeks cycle duration). Transition from stable disease to progression implied the interruption of second-line treatment and administration of a third-line chemotherapy (72%) or best supportive care (28%). According to the National Health System (NHS) perspective only direct costs were considered. Cost estimation (€ , 2015) included pharmaceutical and administration cost, adverse event management and hospital and medical visits consumption. Ex-factory price with mandatory deduction was applied for drug cost estimation. Costs and outcomes were 3% annually discounted. Sensitivity analyses (SA) were performed. Results: Administration of aflibercept + FOLFIRI as second-line treatment on BES was more effective than FOLFIRI, yielding 1.92 LYG (23 life-months gained) compared to 1.55 LYG (18.6 months). Aflibercept + FOLFIRI accounted a total cost of € 40,449, compared to € 25,698 estimated for FOLFIRI. The incremental cost-effectiveness analysis provided a € 33,373/LYG ratio for aflibercept in combination with FOLFIRI versus FOLFIRI for BES. SA results confirmed the model robustness. Conclusions: According to a post-hoc analysis, aflibercept in combination with FOLFIRI could increase overall survival versus FOLFIRI on BES. Aflibercept + FOLFIRI could be an efficient strategy for second-line treatment in specific mCRC patients for the Spanish NHS.

Cite

CITATION STYLE

APA

Echave, M., Oyagüez, I., Lamas, M., Rubio, M., & Subirà, R. (2015). Aflibercept in Combination with Folfiri in Patients with Metastatic Colorectal Cancer: Cost-Effectiveness Based on Velour Best Efficacy Subgroup Post-Hoc Analysis. Value in Health, 18(7), A454. https://doi.org/10.1016/j.jval.2015.09.1153

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free