Cost-effectiveness of FOLFIRI + cetuximab vs FOLFIRI + bevacizumab in the first-line treatment of RAS wild-type metastatic colorectal cancer in Germany: data from the FIRE-3 (AIO KRK-0306) study

Figures & data

Figure 1. Three-state partitioned survival cost-utility model.

Figure 2. Modeled overall survival based on directly including Kaplan-Meier (KM) data of the final RAS wild-type population in the FIRE-3 trial (this graph is based on Excel, and KM steps are not perfectly translated into Excel). Abbreviation. IPD, individual patient data.

Figure 3. Modeled progression-free survival based on directly including Kaplan-Meier (KM) data of the final RAS wild-type population in the FIRE-3 trial (this graph is based on Excel, and KM steps are not perfectly translated into Excel). Abbreviation. IPD, individual patient data.

Table 1. Incremental cost-effectiveness ratios.

Base Case	Costs, €	LYs	QALYs	Discounted
				ICER (cost per LY gained), €	ICUR (cost per QALY gained), €
mITT RAS wt population KM data followed by best-fitting parametric model (OS: Weibull; PFS: log logistic)
FOLFIRI-cet (FIRE-3 IPD)	108,506	2.97	2.31	36,360	47,250
FOLFIRI-bev (FIRE-3 IPD)	83,665	2.29	1.78
Increment	24,841	0.68	0.53
RAS wt patients with LS primary tumor location (subgroup) KM data followed by best-fitting parametric model (OS: Weibull; PFS: log logistic)
FOLFIRI-cet (FIRE-3 IPD)	113,577	3.33	2.59	30,848	39,999
FOLFIRI-bev (FIRE-3 IPD)	85,276	2.41	1.88
Increment	28,302	0.92	0.71
RAS wt patients with LLD (subgroup) KM data followed by best-fitting parametric model (OS: log logistic; PFS: log logistic)
FOLFIRI-cet (FIRE-3 IPD)	126,192	4.20	3.26	20,862	27,075
FOLFIRI-bev (FIRE-3 IPD)	94,714	2.69	2.10
Increment	31,478	1.51	1.16

Abbreviations. bev, bevacizumab; cet, cetuximab; ICER, incremental cost-effectiveness ratio; ICUR, incremental cost-utility ratio; IPD, individual patient data; KM, Kaplan-Meier; LLD, liver-limited disease; LY, life-year; mITT, modified intention to treat; OS, overall survival; PFS, progression-free survival; QALY, quality-adjusted life-year; wt, wild type.

Figure 4. One-way sensitivity analyses in RAS wild-type patient population.

Figure 5. Probabilistic sensitivity analyses. A, Cost-effectiveness plane, RAS wild-type (wt) patient population (base case). B, Cost-effectiveness acceptability curve, RAS wt patient population (base case). Abbreviations. ICER, incremental cost-effectiveness ratio; IPD, individual patient data; PSA, probabilistic sensitivity analysis; QALY, quality-adjusted life-year; WTP, willingness to pay.