Bevacizumab for Metastatic Colorectal Cancer: A Global cost-effectiveness Analysis

Daniel A. Goldstein MD, Qiushi Chen BS, Turgay Ayer PhD, Kelvin KW Chan MD MSc, Kiran Virik MBBS MMed FRACP, Ariel Hammerman PhD, Baruch Brenner MD, Christopher R. Flowers MD MS, Peter S Hall MBChB PhD

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In the US, the addition of bevacizumab to 1st-line chemotherapy in metastatic colorectal cancer (mCRC) has been demonstrated to provide 0.10 quality-adjusted life years (QALYs) at an incremental cost-effectiveness ratio (ICER) of $571,000/QALY. Due to variability in pricing, value for money may be different in other countries. Our objective was to establish the cost-effectiveness of bevacizumab in mCRC in the US, UK, Canada, Australia, and Israel.

Methods: We performed the analysis using a previously established Markov model for mCRC. Input data for efficacy, adverse events and quality of life were considered to be generalizable and therefore identical for all countries. We used country specific prices for medications, administration, and other health service costs. All costs were converted from local currency to US dollars at the exchange rates in March 2016. We conducted one-way and probabilistic sensitivity analyses (PSA) to assess the model robustness across parameter uncertainties.

Results: Base case results demonstrated that the highest ICER was in the US ($571,000/QALY) and the lowest was in Australia ($277,000/QALY). In Canada, UK and Israel, ICERs ranged between $351,000 and $358,000 per QALY. PSA demonstrated 0% likelihood of bevacizumab being cost-effective in any country at a willingness to pay threshold of $150,000 per QALY.
Original languageEnglish
JournalOncologist
Volume22
Issue number6
Early online date7 Jun 2017
DOIs
Publication statusPublished - Jun 2017

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