P-233 - Economic impact of biomarker-based anti EGFR therapies in metastatic colorectal cancer in Austria

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Bioethics, Legal, and Economic Issues
Colon Cancer
Rectal Cancer
Presenter D. Niedersuess-Beke
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors D. Niedersuess-Beke1, M. Schiffinger2, R. Mader3
  • 1Department Of Medicine I, Center For Oncology, Haematology And Palliative Care, Wilhelminenspital, Vienna/AT
  • 2Vienna University of Economics and Business, Vienna/AT
  • 3Comprehensive Cancer Center of the Medical University of Vienna, Vienna/AT

Abstract

Introduction

As the third most common type of cancer in the world, colorectal cancer is a burden to mankind. It is also a burden to the health-care system ranked on the second place in the national cancer care costs in the US. Due to multimodal therapy options including monoclonal antibodies, median survival in metastatic disease improved by more than two years within the last decade. The aim of our investigation was to exemplify the cost impact of using predictive biomarker scenarios for patient pre-selection to guide systemic anti- Epidermal Growth Factor Receptor (EGFR) treatment in metastatic colorectal cancer (mCRC) in Austria.

Methods

We performed an economic analysis including a cost-effectiveness analysis (CEA) for the combination of EGFR inhibitors (cetuximab or panitumumab) with standard chemotherapy (FOLFOX, FOLFIRI) in the first line treatment of mCRC. The calculations (treatment duration, days of hospitalization and visits for side effects) were based on real-life data of 47 patients. An analysis for the various marker scenarios was used to estimate the incremental cost-effectiveness ratio between marker testing and no testing at all. Clinical outcome inputs were taken from published studies with a level of evidence 1. Calculations were based on country specific direct costs (in Euro, year 2013). Setting: One private and one public oncological department in Austria.

Results

On an average single patient basis, simple KRAS testing amounts to a minimum saving of more than 1.100 EUR per month, which can be increased with all RAS family members testing up to 1.800 EUR per month. In Austria, with an incidence of 1100 patients per year, cost reductions up to 16, 25 or even 34% could be reached when using biomarkers with higher selection accuracy. Based on available efficacy data the incremental cost per life year gained was estimated to be 26.276 EUR for the KRAS scenario (selection accuracy: 35%), 9.686 EUR for the all RAS scenario (selection accuracy: 55%) and 3.948 EUR for a future but achievable biomarker scenario (selection accuracy: 75%).

Conclusion

This, testing predictive biomarkers is cost saving in the therapy of mCRC. Given the substantial financial relief for the healthcare system, research aimed at implementation of these biomarkers in the clinical setting should therefore be given highest priority and the required resources.