Evidence map›Paper›PMID 37553566›Full record

ArticleBMC cancer2023

Cetuximab as first-line treatment for metastatic colorectal cancer (mCRC): a model-based economic evaluation in Indonesia setting.

Septiara Putri, Siti Rizny F Saldi, Levina Chandra Khoe, Ery Setiawan, Amila Megraini, Benjarin Santatiwongchai, Ryan R Nugraha, Vetty Y Permanasari, Mardiati Nadjib, Sudigdo Sastroasmoro and 1 more

Open access · goldAbstract read
In one paragraph

Article in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 3 countries.

Septiara PutriHealth Policy and Administration Department, Faculty of Public Health, University of Indonesia, Depok, West Java, 16424, Indonesia. septiaraputri@ui.ac.id.
Siti Rizny F SaldiCenter for Clinical Epidemiology and Evidence-Based Medicine (CEEBM), Cipto Mangunkusomo Hospital, Jakarta, 10430, Indonesia.
Levina Chandra KhoeDepartment of Community Medicine, Faculty of Medicine, University of Indonesia, Jakarta, 10430, Indonesia.
Ery SetiawanCenter for Health Economics and Policy Studies (CHEPS), University of Indonesia, Depok, West Java, 16424, Indonesia.
Amila MegrainiCenter for Health Economics and Policy Studies (CHEPS), University of Indonesia, Depok, West Java, 16424, Indonesia.
Benjarin SantatiwongchaiHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, 11000, Thailand.
Ryan R NugrahaCenter for Population, Family, and Health, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, 2610, Belgium.
Vetty Y PermanasariHealth Policy and Administration Department, Faculty of Public Health, University of Indonesia, Depok, West Java, 16424, Indonesia.
Mardiati NadjibHealth Policy and Administration Department, Faculty of Public Health, University of Indonesia, Depok, West Java, 16424, Indonesia.
Sudigdo SastroasmoroIndonesian Health Technology Assessment Committee, Jakarta, 12950, Indonesia.
Armansyah ArmansyahCenter for Health Financing and Insurance, Ministry of Health Republic of Indonesia, Jakarta, 12950, Indonesia.
University of Indonesia · IDHealth Intervention and Technology Assessment Program · THMinistry of Health · IDRumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo · IDUniversity of Antwerp · BE

Funding

BPJS Kesehatan 208/UN2.F10.PKEKK/HKP.5/2017
6 · The paper itself

Abstract

objectivesTo assess the cost-effectiveness of cetuximab in combination with chemotherapy fluorouracil, oxaliplatin, and leucovorin (FOLFOX) or fluorouracil, irinotecan and leucovorin (FOLFIRI) compared to standard chemotherapy alone as a first-line treatment for metastatic colorectal cancer (mCRC) with positive KRAS wild type patients in Indonesia.

methodsA cost-utility analysis applying Markov model was constructed, with a societal perspective. Clinical evidence was derived from published clinical trials. Direct medical costs were gathered from hospital billings. Meanwhile, direct non-medical costs, indirect costs, and utility data were collected by directly interviewing patients. We applied 3% discount rate for both costs and outcomes. Probabilistic sensitivity analysis was performed to explore the model's uncertainty. Additionally, using payer perspective, budget impact analysis was estimated to project the financial impact of treatment coverage.

resultsThere was no significant difference in life years gained (LYG) between cetuximab plus FOLFOX/FOLFIRI and chemotherapy alone. The incremental QALY was only one month, and the incremental cost-effectiveness ratio (ICER) was approximately IDR 3 billion/QALY for cetuximab plus chemotherapy. Using 1-3 GDP per capita (IDR 215 million or USD 14,350) as the current threshold, the cetuximab plus chemotherapy was not cost-effective. The budget impact analysis resulted that if cetuximab plus chemotherapy remain included in the benefits package under the Indonesian national health insurance (NHI) system, the payer would need more than IDR 1 trillion for five years.

conclusionsThe combination of cetuximab and chemotherapy for mCRC is unlikely cost-effective and has a substantial financial impact on the system.

Indexed as

Colonic NeoplasmsColorectal NeoplasmsRectal NeoplasmsAntibodies, MonoclonalAntineoplastic Combined Chemotherapy ProtocolsCamptothecinCetuximabCost-Benefit AnalysisFluorouracilHumansIndonesiaLeucovorinOxaliplatinAntibodies, MonoclonalCamptothecinCetuximabFluorouracilLeucovorinOxaliplatinCetuximabColorectal cancerCost utility analysisEconomic evaluation

Identifiers

PMID37553566
PMCPMC10408081
OpenAlexW4385663807

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.