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Comparative Study
. 2017 Oct 17;17(1):691.
doi: 10.1186/s12885-017-3679-5.

Cost-effectiveness analysis of XELOX versus XELOX plus bevacizumab for metastatic colorectal cancer in a public hospital school

Andrea Queiróz Ungari  1 , Leonardo Régis Leira Pereira  2 , Altacílio Aparecido Nunes  3 , Fernanda Maris Peria  4
Affiliations
Comparative Study

Cost-effectiveness analysis of XELOX versus XELOX plus bevacizumab for metastatic colorectal cancer in a public hospital school

Andrea Queiróz Ungari et al. BMC Cancer. .

Abstract

Background: Metastatic colorectal cancer imposes a substantial burden on patients and society. Over the last years, progresses in the treatment have been made especially due to the introduction of monoclonal antibodies, such as bevacizumab which, on the other hand, has considerably increased the costs of treatment. We performed a cost-effectiveness analysis of bevacizumab plus XELOX in comparison with XELOX alone in metastatic colorectal cancer in first-line therapy, from the perspective of a public hospital school in Brazil.

Methods: This was a cost-effectiveness analysis performed by a decision tree and Markov models. Costs were expressed in local currency and outcomes were expressed in months of life gained. The model was constructed using the TreeAge Pro 2013® software.

Results: The incremental difference in years of life gained was 2.25 months, with an extra cost of 47,833.57 BRL, resulting in an incremental cost-effectiveness of 21,231.43 BRL per month of life gained.

Conclusions: Although the XELOX plus bevacizumab regimen is a more expensive and more effective treatment than XELOX, it does not fit the reimbursement values fixed by the public healthcare system in Brazil.

Keywords: Bevacizumab; Brazil; Colorectal Neoplasms; Cost-effectiveness evaluation; Unified health system.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Ethics Committee of the Medical School of Ribeirão Preto - University of São Paulo on April 17, 2013 (number 956/2013). The waiver of the written informed consent to patients was requested and approved in this study according to Resolution n°. 466/2012 of the Brazilian Ministry of Health.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Tornado diagram showing incremental cost-effectiveness ratio after the inclusion of minimum and maximum values of the parameters to the model
Fig. 2
Fig. 2
Results of probabilistic sensitivity analysis
Fig. 3
Fig. 3
Acceptability curve of the Markov model comparing the strategies XELOX and XELOX plus bevacizumab used in the first line in the treatment of patients with metastatic colorectal cancer
See this image and copyright information in PMC

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