Gihan Elsisi, Hana Abdul Kareem, Abdelaziz Alaseiri, Abdullah Alsharm, Mohamed Al Garni, Hajer Al-Mudaiheem, Fouad Alnagar, Hazem Lotfy, Mohamed Ouda, Ahmed Elshehri
{"title":"Costs of Adverse Event Management Associated with First-Line Cetuximab or Panitumumab in Metastatic Colorectal Cancer Patients in Saudi Arabia.","authors":"Gihan Elsisi, Hana Abdul Kareem, Abdelaziz Alaseiri, Abdullah Alsharm, Mohamed Al Garni, Hajer Al-Mudaiheem, Fouad Alnagar, Hazem Lotfy, Mohamed Ouda, Ahmed Elshehri","doi":"10.36469/001c.130878","DOIUrl":null,"url":null,"abstract":"<p><p><b>Introduction:</b> In Saudi Arabia, patients with metastatic colorectal cancer (mCRC) with wild-type RAS mutations may be treated with either cetuximab plus chemotherapy (CET + CT) or panitumumab plus chemotherapy (PAN + CT), which are epidermal growth factor receptor (EGFR) antibodies. This study calculated the costs of adverse event (AE) management linked to anti-EGFR treatment in Saudi Arabia's national health budget from payer and societal perspectives. <b>Methods:</b> An adaptation of a global model developed in Microsoft Excel® was performed to estimate the costs of AE management associated with the first-line treatment (CET + CT and PAN + CT) of RAS wild-type mCRC patients in Saudi healthcare settings. The frequencies of common and highly common AEs were sourced from the summaries of product characteristics of CET and PAN, whereas AE severity was captured from a meta-analysis. Unit costs in Saudi Riyal (SAR) were obtained from the National Guard of Health Affairs and Ministry of Health 2024 price lists. The model assumptions, inputs, and results were validated using a local Delphi panel. <b>Results:</b> Within the Saudi payer perspective model, treatment with CET + CT vs PAN + CT resulted in average population cost savings of SAR 9 246 133 (4 741 606 international dollars [Intl <math><mo>]</mo> <mo>)</mo> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mo>-</mo> <mi>p</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mi>a</mi> <mi>v</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>s</mi> <mi>o</mi> <mi>f</mi> <mi>S</mi> <mi>A</mi> <mi>R</mi> <mn>20</mn> <mrow><mo> </mo></mrow> <mn>321</mn> <mo>(</mo> <mi>I</mi> <mi>n</mi> <mi>t</mi> <mi>l</mi></math> 10 421) for severe AEs, and average population cost savings of SAR 16 039 427 (Intl <math><mn>8</mn> <mrow><mo> </mo></mrow> <mn>225</mn> <mrow><mo> </mo></mrow> <mn>347</mn> <mo>)</mo> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mo>-</mo> <mi>p</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mi>a</mi> <mi>v</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>s</mi> <mi>o</mi> <mi>f</mi> <mi>S</mi> <mi>A</mi> <mi>R</mi> <mn>35</mn> <mrow><mo> </mo></mrow> <mn>251</mn> <mo>(</mo> <mi>I</mi> <mi>n</mi> <mi>t</mi> <mi>l</mi></math> 18 077) for all-grade AEs. On the other hand, within the Saudi societal perspective model, treatment with CET + CT vs PAN + CT resulted in average population cost savings of SAR 11 386 314 (Intl <math><mn>5</mn> <mrow><mo> </mo></mrow> <mn>839</mn> <mrow><mo> </mo></mrow> <mn>135</mn> <mo>)</mo> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mo>-</mo> <mi>p</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mi>a</mi> <mi>v</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>s</mi> <mi>o</mi> <mi>f</mi> <mi>S</mi> <mi>A</mi> <mi>R</mi> <mn>25</mn> <mrow><mo> </mo></mrow> <mn>025</mn> <mo>(</mo> <mi>I</mi> <mi>n</mi> <mi>t</mi> <mi>l</mi></math> 12 833) for severe AEs, while resulting in average population cost savings of SAR 18 179 608 (Intl <math><mn>9</mn> <mrow><mo> </mo></mrow> <mn>322</mn> <mrow><mo> </mo></mrow> <mn>875</mn> <mo>)</mo> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>p</mi> <mi>e</mi> <mi>r</mi> <mi>p</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>e</mi> <mi>n</mi> <mi>t</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mi>a</mi> <mi>v</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>s</mi> <mi>o</mi> <mi>f</mi> <mi>S</mi> <mi>A</mi> <mi>R</mi> <mn>39</mn> <mrow><mo> </mo></mrow> <mn>955</mn> <mo>(</mo> <mi>I</mi> <mi>n</mi> <mi>t</mi> <mi>l</mi></math> 20 489) for all grade AEs. <b>Conclusion:</b> The CET + CT regimen was associated with a lower AE frequency than the PAN + CT regimen for the treatment of untreated RAS wild-type mCRC patients, thus resulting in AE management cost savings from both the Saudi payer and societal perspectives. These substantial cost savings may mitigate the financial burden of mCRC in Saudi healthcare settings.</p>","PeriodicalId":16012,"journal":{"name":"Journal of Health Economics and Outcomes Research","volume":"12 1","pages":"106-112"},"PeriodicalIF":2.3000,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890290/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Health Economics and Outcomes Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36469/001c.130878","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
摘要
简介:在沙特阿拉伯,RAS野生型突变的转移性结直肠癌(mCRC)患者可以使用西妥昔单抗联合化疗(CET + CT)或帕尼单抗联合化疗(PAN + CT)进行治疗,这两种药物都是表皮生长因子受体(EGFR)抗体。本研究从支付方和社会角度计算了沙特阿拉伯国家卫生预算中与抗表皮生长因子受体治疗相关的不良事件(AE)管理成本。方法:对 Microsoft Excel® 中开发的全球模型进行了调整,以估算沙特医疗环境中 RAS 野生型 mCRC 患者一线治疗(CET + CT 和 PAN + CT)的相关 AE 管理成本。常见和高发 AE 的频率来自 CET 和 PAN 的产品特征概要,而 AE 的严重程度则来自一项荟萃分析。以沙特里亚尔(SAR)为单位的单位成本来自国家卫生事务卫队和卫生部 2024 年价目表。模型假设、输入和结果由当地德尔菲小组进行验证。结果:在沙特支付方视角模型中,使用 CET + CT 与 PAN + CT 相比,治疗严重 AE 的平均人群成本可节省 9 246 133 沙特里亚尔(4 741 606 美元 [Intl ]),而治疗严重 AE 的平均人群成本可节省 S A R 20 321(I n t l 10 421)、对于所有等级的急性呼吸道感染,平均每人可节省 16 039 427 里亚尔(8 225 347 英镑)的费用,平均每人可节省 35 251 里亚尔(18 077 英镑)的费用。另一方面,在沙特社会视角模型中,使用 CET + CT 与 PAN + CT 相比,治疗严重 AE 平均可节省 11 386 314 沙特里亚尔(5 839 135 英镑)的人口成本,而治疗严重 AE 平均可节省 S A R 25 025(12 833 英镑)的人口成本、同时,所有等级的急性呼吸道感染平均可节约 18 179 608 里亚尔(9 322 875 英镑)的人口成本和 39 955 里亚尔(20 489 英镑)的医疗费用。结论:在治疗未经治疗的 RAS 野生型 mCRC 患者时,CET + CT 方案的 AE 发生率低于 PAN + CT 方案,因此从沙特支付方和社会角度来看,都能节省 AE 管理成本。这些可观的成本节约可减轻沙特医疗机构对 mCRC 的经济负担。
Costs of Adverse Event Management Associated with First-Line Cetuximab or Panitumumab in Metastatic Colorectal Cancer Patients in Saudi Arabia.
Introduction: In Saudi Arabia, patients with metastatic colorectal cancer (mCRC) with wild-type RAS mutations may be treated with either cetuximab plus chemotherapy (CET + CT) or panitumumab plus chemotherapy (PAN + CT), which are epidermal growth factor receptor (EGFR) antibodies. This study calculated the costs of adverse event (AE) management linked to anti-EGFR treatment in Saudi Arabia's national health budget from payer and societal perspectives. Methods: An adaptation of a global model developed in Microsoft Excel® was performed to estimate the costs of AE management associated with the first-line treatment (CET + CT and PAN + CT) of RAS wild-type mCRC patients in Saudi healthcare settings. The frequencies of common and highly common AEs were sourced from the summaries of product characteristics of CET and PAN, whereas AE severity was captured from a meta-analysis. Unit costs in Saudi Riyal (SAR) were obtained from the National Guard of Health Affairs and Ministry of Health 2024 price lists. The model assumptions, inputs, and results were validated using a local Delphi panel. Results: Within the Saudi payer perspective model, treatment with CET + CT vs PAN + CT resulted in average population cost savings of SAR 9 246 133 (4 741 606 international dollars [Intl 10 421) for severe AEs, and average population cost savings of SAR 16 039 427 (Intl 18 077) for all-grade AEs. On the other hand, within the Saudi societal perspective model, treatment with CET + CT vs PAN + CT resulted in average population cost savings of SAR 11 386 314 (Intl 12 833) for severe AEs, while resulting in average population cost savings of SAR 18 179 608 (Intl 20 489) for all grade AEs. Conclusion: The CET + CT regimen was associated with a lower AE frequency than the PAN + CT regimen for the treatment of untreated RAS wild-type mCRC patients, thus resulting in AE management cost savings from both the Saudi payer and societal perspectives. These substantial cost savings may mitigate the financial burden of mCRC in Saudi healthcare settings.