COST-EFFECTIVENESS ANALYSIS OF TRIFLURIDINE/TIPIRACIL PLUS BEVACIZUMAB COMBINATION THERAPY AS THIRD-LINE TREATMENT FOR METASTATIC COLORECTAL CANCER IN JAPAN
Author(s)
Nanaka Komaki, BS1, Mao Yamaguchi, MS2, Kensuke Moriwaki, BS, MS, PhD3.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan university, Kusatsu, Japan, 3Associate Professor, Ritsumeikan University, Kyoto, Japan.
1Ritsumeikan University, Kusatsu, Japan, 2Ritsumeikan university, Kusatsu, Japan, 3Associate Professor, Ritsumeikan University, Kyoto, Japan.
OBJECTIVES: Trifluridine/tipiracil (FTD-TPI) monotherapy is one of the standard third-line treatments for refractory metastatic colorectal cancer, but its efficacy is unsatisfactory. The combination of FTD-TPI and bevacizumab demonstrated improved overall survival compared with FTD-TPI monotherapy in the international phase III SUNLIGHT trial. However, the trial didn’t include Japanese patients, and the cost-effectiveness within the Japanese healthcare system remains unclear. This study aimed to evaluate the cost-effectiveness of FTD-TPI and bevacizumab combination therapy from the payer’s perspective in Japan.
METHODS: A partitioned survival analysis model was developed to predict costs and quality-adjusted life years (QALYs) in the FTD-TPI monotherapy group and the FTD-TPI and bevacizumab combination therapy group. Survival data were derived from the phase III SUNLIGHT trial. Drug costs for FTD-TPI and bevacizumab were calculated using drug price standards. Other cost parameters were estimated by using the JMDC claims database. Lifetime horizon and discount rate of 2% was applied. Utility weights estimated primarily based on previous studies; however, values for some health states were supplemented using data from other clinical trials and relevant literature. The incremental cost-effectiveness ratio (ICER) of combination therapy compared with monotherapy was estimated. Sensitivity analysis (SA) was performed to assess parameter uncertainty.
RESULTS: Compared with monotherapy, combination therapy incurred an additional cost of JPY2,374,806 and conferred an additional 0.237 QALY. This resulted in the ICER of JPY10,038,388 /QALY gained. SA showed that the parameter with the largest influence was utility weight of PD in the intervention group, and the ICER ranged from JPY8,477,312 to 12,304,170 /QALY.
CONCLUSIONS: Applying the willingness to pay threshold of JPY15 million/QALY and the current drug price standards, combination therapy was cost-effective compared with monotherapy. These results support the economic value of combination therapy in the Japanese healthcare setting.
METHODS: A partitioned survival analysis model was developed to predict costs and quality-adjusted life years (QALYs) in the FTD-TPI monotherapy group and the FTD-TPI and bevacizumab combination therapy group. Survival data were derived from the phase III SUNLIGHT trial. Drug costs for FTD-TPI and bevacizumab were calculated using drug price standards. Other cost parameters were estimated by using the JMDC claims database. Lifetime horizon and discount rate of 2% was applied. Utility weights estimated primarily based on previous studies; however, values for some health states were supplemented using data from other clinical trials and relevant literature. The incremental cost-effectiveness ratio (ICER) of combination therapy compared with monotherapy was estimated. Sensitivity analysis (SA) was performed to assess parameter uncertainty.
RESULTS: Compared with monotherapy, combination therapy incurred an additional cost of JPY2,374,806 and conferred an additional 0.237 QALY. This resulted in the ICER of JPY10,038,388 /QALY gained. SA showed that the parameter with the largest influence was utility weight of PD in the intervention group, and the ICER ranged from JPY8,477,312 to 12,304,170 /QALY.
CONCLUSIONS: Applying the willingness to pay threshold of JPY15 million/QALY and the current drug price standards, combination therapy was cost-effective compared with monotherapy. These results support the economic value of combination therapy in the Japanese healthcare setting.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE19
Topic
Economic Evaluation
Disease
SDC: Oncology