PDF(Pubmed)
Abstract：
Aim: The objective of this study was to compare adverse event (AE) management costs for fruquintinib, regorafenib, trifluridine/tipiracil (T/T) and trifluridine/tipiracil+bevacizumab (T/T+bev) for patients with metastatic colorectal cancer (mCRC) previously treated with at least two prior lines of therapy from the US commercial and Medicare payer perspectives. Materials & methods: A cost-consequence model was developed to calculate the per-patient and per-patient-per-month (PPPM) AE costs using rates of grade 3/4 AEs with incidence ≥5% in clinical trials, event-specific management costs and duration treatment. Anchored comparisons of AE costs were calculated using a difference-in-differences approach with best supportive care (BSC) as a common reference. AE rates and treatment duration were obtained from clinical trials: FRESCO and FRESCO-2 (fruquintinib), RECOURSE (T/T), CORRECT (regorafenib) and SUNLIGHT (T/T, T/T+bev). AE management costs for the commercial and Medicare perspectives were obtained from publicly available sources. Results: From the commercial perspective, the AE costs (presented as per-patient, PPPM) were: $4015, $1091 for fruquintinib (FRESCO); $4253, $1390 for fruquintinib (FRESCO-2); $17,110, $11,104 for T/T (RECOURSE); $9851, $4691 for T/T (SUNLIGHT); $8199, $4823 for regorafenib; and $11,620, $2324 for T/T+bev. These results were consistent in anchored comparisons: the difference-in-difference for fruquintinib based on FRESCO was -$1929 versus regorafenib and -$11,427 versus T/T; for fruquintinib based on FRESCO-2 was -$2257 versus regorafenib and -$11,756 versus T/T. Across all analyses, results were consistent from the Medicare perspective. Conclusion: Fruquintinib was associated with lower AE management costs compared with regorafenib, T/T and T/T+bev for patients with previously treated mCRC. This evidence has direct implications for treatment, formulary and pathways decision-making in this patient population.
摘要：
目的：本研究的目的是比较氟喹替尼的不良事件（AE）管理成本，Regorafenib,从美国商业和医疗保险支付者的角度来看,三氟尿苷/替吡草胺(T/T)和三氟尿苷/替吡草胺+贝伐单抗(T/T+bev)治疗转移性结直肠癌(mCRC)患者之前接受过至少两种先前治疗方案。材料与方法：开发了成本-后果模型，以使用临床试验中发生率≥5％的3/4级不良事件发生率来计算每位患者和每位患者每月（PPPM）的不良事件成本。特定事件的管理成本和持续时间处理。AE成本的锚定比较是使用差异差异方法计算的，最佳支持护理（BSC）作为通用参考。AE发生率和治疗持续时间来自临床试验：FRESCO和FRESCO-2（氟喹替尼），RECOURSE(T/T),正确的(regorafenib)和阳光(T/T，T/T+bev)。商业和医疗保险观点的AE管理成本是从公开可用的来源获得的。结果：从商业角度来看，AE成本(按每位患者计算，PPPM）为：4015美元，福喹替尼1091美元（FRESCO）；4253美元，福喹替尼1390美元（FRESCO-2）；$17,110，$11,104T/T（RECOURSE）；$9851，$4691T/T（SUNLIGHT）；$8199，regorafenib$4823；$11,620，$这些结果在锚定比较中是一致的：基于FRESCO的fruquintinib的差异为-1929美元与regorafenib和-11,427美元与T/T；基于FRESCO-2的fruquintinib的差异为-2257美元与regorafenib和-11,756美元与T/T。在所有分析中，从医疗保险的角度来看，结果是一致的。结论：与regorafenib相比，Fruquintinib具有较低的AE管理成本，先前治疗过的mCRC患者的T/T和T/T+bev。这个证据对治疗有直接的影响,该患者人群的处方和路径决策。
