Cost-minimization analysis of panitumumab compared with cetuximab for first-line treatment of patients with wild-type RAS metastatic colorectal cancer

Abstract

Objective:

To compare the costs of first-line treatment with panitumumab + FOLFOX in comparison to cetuximab + FOLFIRI among patients with wild-type (WT) RAS metastatic colorectal cancer (mCRC) in the US.

Methods:

A cost-minimization model was developed assuming similar treatment efficacy between both regimens. The model estimated the costs associated with drug acquisition, treatment administration frequency (every 2 weeks for panitumumab, weekly for cetuximab), and incidence of infusion reactions. Average anti-EGFR doses were calculated from the ASPECCT clinical trial, and average doses of chemotherapy regimens were based on product labels. Using the medical component of the consumer price index, adverse event costs were inflated to 2014 US dollars, and all other costs were reported in 2014 US dollars. The time horizon for the model was based on average first-line progression-free survival of a WT RAS patient, estimated from parametric survival analyses of PRIME clinical trial data.

Results:

Relative to cetuximab + FOLFIRI in the first-line treatment of WT RAS mCRC, the cost-minimization model demonstrated lower projected drug acquisition, administration, and adverse event costs for patients who received panitumumab + FOLFOX. The overall cost per patient for first-line treatment was $179,219 for panitumumab + FOLFOX vs $202,344 for cetuximab + FOLFIRI, resulting in a per-patient saving of $23,125 (11.4%) in favor of panitumumab + FOLFOX.

Conclusions:

From a value perspective, the cost-minimization model supports panitumumab + FOLFOX instead of cetuximab + FOLFIRI as the preferred first-line treatment of WT RAS mCRC patients requiring systemic therapy.

Keywords::

• Cost-minimization – Panitumumab – Cetuximab – FOLFOX – FOLFIRI – Colorectal cancer – First-line

Transparency

Declaration of funding

This study was conducted by RTI Health Solutions under the direction of Amgen and was funded by Amgen. Amgen employees made clinical trial data available for analysis, and offered analytical suggestions. The sponsored research did not put limits on freedom to publish or the content of publication.

Declaration of financial/other relationships

CG and HK are employees of RTI Health Solutions, a consultancy firm that received compensation for the overall economic study design, the analysis, and preparation of this manuscript. GH, JH, GM, and BB are employees of Amgen. They also contributed to the analysis and manuscript preparation. MF, an employee of City of Hope Comprehensive Cancer Center, and LS, an employee of The West Clinic, have previously served as consultants to Amgen and received honoraria from Amgen for speaking engagements; however, they did not receive compensation for their contributions to the study design, data analysis, or preparation of this manuscript. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.