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Cost-effectiveness of Trifluridine/tipiracil for Previously Treated Metastatic Colorectal Cancer in England and Wales.
Bullement, Ash; Underhill, Stuart; Fougeray, Ronan; Hatswell, Anthony James.
Afiliação
  • Bullement A; BresMed Health Solutions, Sheffield, UK.
  • Underhill S; Servier Laboratories Ltd, Wexham, Slough, Berkshire, UK.
  • Fougeray R; Department of Biostatistics Servier, IRIS, Suresnes, France.
  • Hatswell AJ; BresMed Health Solutions, Sheffield, UK; Department of Statistical Science, University College London, London, UK. Electronic address: ahatswell@deltahat.co.uk.
Clin Colorectal Cancer ; 17(1): e143-e151, 2018 03.
Article em En | MEDLINE | ID: mdl-29110922
ABSTRACT

BACKGROUND:

Treatment options at third-line and beyond for patients with late-line metastatic colorectal cancer (mCRC) are limited, and outcomes are poor with best supportive care (BSC). This study investigated the cost-effectiveness of trifluridine/tipiracil and regorafenib relative to BSC alone in patients with mCRC who have been previously treated with, or are not considered candidates for, standard chemotherapies. MATERIALS AND

METHODS:

A partitioned survival model was constructed to assess the lifetime costs and benefits accrued by patients. Clinical data were derived from the pivotal phase III (Randomized, Double-Blind, Phase 3 Study of TAS-102 plus Best Supportive Care [BSC] versus Placebo plus BSC in Patients with Metastatic Colorectal Cancer Refractory to Standard Chemotherapies [RECOURSE]) and supporting phase II (J003-10040030) randomized controlled trial of trifluridine/tipiracil + BSC versus placebo + BSC, as well as the phase III Colorectal Cancer Treated With Regorafenib or Placebo After Failure of Standard Therapy (CORRECT) randomized controlled trial of regorafenib, and were extrapolated to estimate lifetime outcomes. Costs were taken from published sources, and health effects sourced from previous mCRC studies.

RESULTS:

Trifluridine/tipiracil was associated with a 0.27 incremental life year versus BSC alone, which corresponds to a 0.17 quality-adjusted life year gain. The incremental cost of treatment with trifluridine/tipiracil was £8,479, resulting in an incremental cost-effectiveness ratio of £51,194 per quality-adjusted life year gained. Trifluridine/tipiracil was shown to dominate regorafenib (improve outcomes with reduced costs). Sensitivity analyses showed principal areas of uncertainty were survival estimates and patient utility.

CONCLUSIONS:

The results show that trifluridine/tipiracil is more clinically and cost-effective than regorafenib, with clinical outcomes greatly exceeding those for patients treated with BSC alone. Based on the results of the analysis, trifluridine/tipiracil offers an important new treatment option for patients with mCRC maintaining good performance status at the end of life.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Protocolos de Quimioterapia Combinada Antineoplásica / Terapia de Salvação / Trifluridina Tipo de estudo: Clinical_trials / Health_economic_evaluation Aspecto: Patient_preference Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Clin Colorectal Cancer Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Protocolos de Quimioterapia Combinada Antineoplásica / Terapia de Salvação / Trifluridina Tipo de estudo: Clinical_trials / Health_economic_evaluation Aspecto: Patient_preference Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Clin Colorectal Cancer Ano de publicação: 2018 Tipo de documento: Article