Treatment pathways and associated costs of metastatic colorectal cancer in Greece.
Braf600 mutation
Costs
Disease burden
Greece
Metastatic colorectal cancer
Treatment pathways
Journal
Cost effectiveness and resource allocation : C/E
ISSN: 1478-7547
Titre abrégé: Cost Eff Resour Alloc
Pays: England
ID NLM: 101170476
Informations de publication
Date de publication:
14 Feb 2022
14 Feb 2022
Historique:
received:
03
12
2021
accepted:
19
01
2022
entrez:
15
2
2022
pubmed:
16
2
2022
medline:
16
2
2022
Statut:
epublish
Résumé
Colorectal cancer (CRC) is the second leading cause of cancer in Europe, with 1.931.590 people newly diagnosed in 2020. The purpose of this study is the investigation of treatment options and healthcare resource metastatic CRC (mCRC) in Greece. This study is based on the information collected in November 2020 by an expert panel comprising of 6 medical oncologists from major public and private centers around Greece. A 3-round survey was undertaken, according to Delphi method. The treatment phases studied were: pre-progression; disease progression and terminal care. Pharmaceutical costs and resource utilization data were considered from the perspective of the Greek National Services Organization (EOPYY). Experts agreed that the anticipated prevalence of RAS mutation in mCRC is 47% (30% RAS/BRAF WT Left, 17% RAS/BRAF WT Right); 8% BRAF while, MSI-H/dMMR are found in 5% of mCRC tumors. Based on mutational status, 74.8% of patients receive biological targeted therapies in combination with fluoropyrimidine/based combination chemotherapy, as 1st line treatment, and 25.2% combination chemotherapy alone. At 2nd line, 58.6% of patients receive biological targeted therapies in combination with chemotherapy, 25.4% immunotherapy, 11% combination chemotherapy and 5% biological targeted therapies. At 3rd line 56% of patients receive combination chemotherapy, 28% biological targeted therapies, 10% biological targeted therapies in combination with chemotherapy and 6% immunotherapy. The weighted annual cost (pharmaceuticals and resource use cost) in 1st line per mCRC patient was calculated at €28,407, in 2nd line €33,568, in 3rd line €25,550. The annual cost beyond 3rd line per patient regardless mutation was €19,501 per mCRC patient. mCRC is a societal challenge for healthcare systems as the treatment is more prolonged but expand patients' survival. Thus, reimbursement decisions should be based not just on the cost of the treatment, but on the magnitude of the benefit of its treatment on patients' survival and quality of life.
Identifiants
pubmed: 35164784
doi: 10.1186/s12962-022-00339-2
pii: 10.1186/s12962-022-00339-2
pmc: PMC8842737
doi:
Types de publication
Journal Article
Langues
eng
Pagination
7Informations de copyright
© 2022. The Author(s).
Références
J Clin Oncol. 2019 Jun 10;37(17):1460-1469
pubmed: 30892987
Ann Oncol. 2019 Apr 1;30(4):510-519
pubmed: 30721924
JAMA. 2009 Oct 21;302(15):1696-7
pubmed: 19843905
Ann Oncol. 2012 Oct;23(10):2479-2516
pubmed: 23012255
World J Gastroenterol. 2014 Nov 7;20(41):15049-59
pubmed: 25386053
Am J Med. 1999 Jan 25;106(1A):3S-6S; discussion 50S-51S
pubmed: 10089106
Lancet. 2011 Jun 18;377(9783):2103-14
pubmed: 21641636
Endoscopy. 2012 Sep;44 Suppl 3:SE31-48
pubmed: 23012121
Ann Oncol. 2016 Aug;27(8):1386-422
pubmed: 27380959
Lancet Oncol. 2013 Nov;14(12):1165-74
pubmed: 24131614
J Clin Oncol. 2021 Feb 1;39(4):273-284
pubmed: 33503393
Clin Gastroenterol Hepatol. 2009 Feb;7(2):198-204
pubmed: 18849013
Onco Targets Ther. 2021 Mar 25;14:2121-2130
pubmed: 33790575
Ann Oncol. 2014 Sep;25 Suppl 3:iii1-9
pubmed: 25190710
Cir Esp. 2017 Feb;95(2):89-96
pubmed: 28189254
Gut. 2017 Apr;66(4):683-691
pubmed: 26818619
N Engl J Med. 2009 Apr 2;360(14):1408-17
pubmed: 19339720
Ann Intern Med. 2011 Jan 4;154(1):22-30
pubmed: 21200035
J Clin Oncol. 2010 Nov 1;28(31):4697-705
pubmed: 20921465
Transl Oncol. 2021 Oct;14(10):101174
pubmed: 34243011
Clin Colon Rectal Surg. 2009 Nov;22(4):191-7
pubmed: 21037809
Gut. 2013 May;62(5):727-34
pubmed: 22490518