Adverse Event Costs Associated With Systemic Therapies for Metastatic Colorectal Cancer Previously Treated With Standard Therapies and Biologics in the United States, Italy, Portugal, and Spain
Author(s)
Hernandez LG1, Paly V1, Padukkavidana T2, Dasari A3, Hubbard J4, Bekaii-Saab T5, Sobrero A6, Elez E7
1Takeda Pharmaceuticals America, Inc., Lexington, MA, USA, 2Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, USA, 3The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 4Mayo Clinic - Rochester, Rochester, MN, USA, 5Mayo Clinic - Phoenix, Phoenix, AZ, USA, 6Azienda Ospedaliera San Martino, Genoa, Italy, 7Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
Presentation Documents
OBJECTIVES: To compare costs of managing adverse events (AEs) associated with fruquintinib, trifluridine/tipiracil (T/T), regorafenib, and T/T+bevacizumab (T/T+bev) for the treatment of patients with metastatic colorectal cancer (mCRC) previously treated with fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy, an anti-vascular endothelial growth factor receptor biologic therapy, and, if RAS wild-type, an anti-epidermal growth factor receptor therapy from the payer perspective in the US, Italy, Portugal, and Spain.
METHODS: AE costs per-patient (PP) and per-patient-per-month (PPPM; PP adjusted by treatment duration) were estimated using incidence of grade 3/4 AEs occurring in ≥5% of patients and median treatment duration, taken from Phase III randomized clinical trial publications for fruquintinib (FRESCO and FRESCO-2), T/T (RECOURSE and SUNLIGHT), regorafenib (CORRECT), and T/T+bev (SUNLIGHT); AE management costs from Healthcare Cost and Utilization Project data (Commercial) and Medicare Acute Inpatient Prospective Payment System Fee Schedule for the US, and from respective Ministry of Health public databases for Italy, Portugal, and Spain – inflated to 2023, as needed. Additionally, anchored comparisons were calculated for fruquintinib, regorafenib, and T/T (based on RECOURSE only) using a difference-in-differences approach with best supportive care (BSC) as the common comparator.
RESULTS: From the US Commercial perspective, PP (PPPM) AE costs were: for fruquintinib $4,015 ($1,091) based on FRESCO and $4,253 ($1,390) based on FRESCO-2; for T/T $17,110 ($11,104) based on RECOURSE and $9,851 ($4,691) based on SUNLIGHT; for regorafenib $8,181 ($4,812); for T/T+bev $11,620 ($2,324). In anchored comparisons with BSC as the common comparator, difference-in-differences resulted in lower AE management costs for fruquintinib based on FRESCO (and based on FRESCO-2, presented in parentheses) vs. regorafenib: -$1,910 (-$2,239) and vs. T/T: -$11,427 (-$11,756). Results were consistent for US Medicare, Italy, Portugal, and Spain.
CONCLUSIONS: Fruquintinib was associated with lower AE management costs compared with regorafenib, T/T, and T/T+bev for patients with mCRC previously treated with standard therapies and biologics.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 6, S1 (June 2024)
Code
EE479
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology