Management Costs of Grade 3/4 Adverse Events Associated with Emerging and Existing Systemic Therapies for Metastatic Colorectal Cancer with at Least Two Prior Lines of Therapy in Italy, Portugal, Spain, and the United States

Speaker(s)

Paly V1, Hernandez LG1, Howe A1, Khanduri P2, Labisa P3, Taglioni A4, Siviero L4, Dasari A5, Eng C6, Hubbard J7, Bekaii-Saab T8, Sobrero A9, Elez E10
1Takeda Pharmaceuticals America, Inc., Lexington, MA, USA, 2Evidera, Toronto, Canada, 3Takeda Farmacêuticos Portugal, Lisbon, Portugal, 4Takeda Italia S.p.A., Roma, Italy, 5Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 6Division Hematology and Oncology, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA, 7Mayo Clinic, Rochester, MN, USA, 8Mayo Clinic, Phoenix, AZ, USA, 9Department of Medical Oncology, Azienda Ospedaliera San Martino, Genoa, Italy, 10Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Institute of Oncology, Barcelona, Spain

Presentation Documents

OBJECTIVES: As new therapies become available for metastatic colorectal cancer (mCRC) it is important to characterize the economic burden associated with managing adverse events (AEs) and their impact on total cost of care. This study estimates the costs of grade 3/4 AEs related to fruquintinib, regorafenib, trifluridine/tipiracil (T/T), and trifluridine/tipiracil+bevacizumab (T/T+bev) for previously treated mCRC in Italy, Portugal, Spain and the United States (US) from Commercial and Medicare payer perspectives.

METHODS: Grade 3/4 AEs occurring in ≥5% of patients for any treatment in an individual trial were identified from the publications of Phase III randomized clinical trials FRESCO and FRESCO-2 (fruquintinib, N=734), RECOURSE and SUNLIGHT (T/T, N=779), CORRECT (regorafenib, N=500), and SUNLIGHT (T/T+bev, N=246). AE management costs (2023) were based on diagnosis-related group codes. For Italy, Portugal, and Spain costs were from their respective Ministry of Health public databases. For the US, Healthcare Cost and Utilization Project data (Commercial perspective) and the Medicare Acute Inpatient Prospective Payment System Fee Schedule were used. The cost per event was multiplied by each AE rate to derive an aggregate AE management cost for every treatment.

RESULTS: Grade 3/4 AE occurring in ≥5% for any treatment included: anemia, asthenia, diarrhea, fatigue, hand foot syndrome, hypertension, leukopenia, neutropenia, rash, thrombocytopenia, and laboratory abnormalities (increased alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, and total bilirubin). AE management costs per patient while on treatment with fruquintinib, regorafenib, T/T and T/T+bev were estimated to be, respectively: Italy: €412, €850, €1,507 and €1,151; Portugal: €1,864, €3,485, €6,129 and €4,954; Spain: €1,283, €2,401, €4,865 and €3,888; US (Commercial): $4,160, $8,181, $14,801 and $11,620; US (Medicare): $2,249, $4,412, $7,515 and $6,125.

CONCLUSIONS: Patients with mCRC previously treated with at least two prior lines of therapy experienced lower costs associated with the management of grade 3/4 AEs when treated with fruquintinib vs. other treatment options.

Code

EE670

Topic

Economic Evaluation, Health Policy & Regulatory

Topic Subcategory

Insurance Systems & National Health Care

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Oncology