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Poster Display session 2

1212 - The cost of adverse event management in patients with RAS wild-type metastatic colorectal cancer treated with first-line cetuximab and panitumumab: an Italian healthcare payer perspective


29 Sep 2019


Poster Display session 2


Tumour Site

Colon and Rectal Cancer


Karl Patterson


Annals of Oncology (2019) 30 (suppl_5): v198-v252. 10.1093/annonc/mdz246


K. Patterson1, S. Bhattacharyya1, N. Personeni2, V. Gebbia3, P. Novelli4, S. Di Matteo5, G. Colombo6, C. Pescott7

Author affiliations

  • 1 Health Economics, BresMed, S1 2DW - Sheffield/GB
  • 2 Department Of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 - Milan/IT
  • 3 University Of Palermo, La Maddalena Hospital, 90145 - Sicily/IT
  • 4 Hta & Market Access, Merck Serono S.p.A., 00176 - Rome/IT
  • 5 Health Economics And Outcomes Research, S.A.V.E. Studi Analisi Valutazioni Economiche srl, 20149 - Milan/IT
  • 6 Department Of Drug Sciences, University of Pavia, 27100 - Pavia/IT
  • 7 Global Evidence And Value Development, Merck Healthcare KGaA, 64293 - Darmstadt/DE


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Abstract 1212


In Italy, previously untreated patients with RAS wild-type metastatic colorectal cancer (mCRC) may receive an epidermal growth factor receptor (EGFR) inhibitor with a chemotherapy regimen (CT). The choice of anti-EGFR, either cetuximab (cet+CT) or panitumumab (pan+CT), depends on various factors, including adverse event (AE) profiles. Although AE profiles will evolve with increasing use and familiarity, the differences in AE profiles can be explored using literature and safety data from the summary of product characteristics (SmPC). The financial impact of these differences on the Italian National Health Service has yet to be estimated.


We developed a model to estimate costs of AE management. Frequencies of common and very common AEs associated with cet+CT or pan+CT were sourced from the respective SmPC.1,2 Applicable resource use costs were obtained from hospital services price lists from the Ministry of Health using the DRG outpatient tariff.3 The national-level financial impact was calculated from the number of cet+CT–eligible patients with mCRC treated in the first line based on published literature, national guidelines, and pan+CT market share. Inputs were validated by practicing Italian oncologists.


All-grade AEs were estimated to be 58.1% lower and grade 3/4 AEs were estimated to be 70.2% lower in patients receiving cet+CT than in those receiving pan+CT. Mean costs of AE management per patient treated with cet+CT and pan+CT were estimated at €1,194 and €2,951, respectively, resulting in average savings of €1,758 (59.6%) per patient. Differences are mainly driven by a lower frequency of AEs that are costly to manage, such as GI disorders. Annual savings could reach €2,191,839 for a population of 1,247 cet+CT–eligible patients with mCRC.


Fewer AEs for cet+CT may result in markedly lower AE management costs vs pan+CT. Although results should be considered together with overall costs and clinical outcomes, cet+CT could decrease cost burden on the Italian National Health Service and AE burden for patients with mCRC.

Clinical trial identification

Editorial acknowledgement

ClinicalThinking, Inc, Hamilton, NJ, USA (funded by Merck Healthcare KGaA, Darmstadt, Germany).

Legal entity responsible for the study

Merck Healthcare KGaA.


Merck Healthcare KGaA.


N. Personeni: Advisory / Consultancy, Speaker Bureau / Expert testimony: Merck Serono. V. Gebbia: Honoraria (self): Merck; Honoraria (self): Amgen; Honoraria (self): Roche. P. Novelli: Full / Part-time employment: Merck Serono S.p.A. S. Di Matteo: Research grant / Funding (institution): Merck. G. Colombo: Research grant / Funding (institution): Merck. C. Pescott: Full / Part-time employment: Merck Healthcare KGaA. All other authors have declared no conflicts of interest.

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