Disease Management Costs in Late-Line Metastatic Colorectal Cancer: A Portuguese Perspective Using Structured Expert Elicitation
Author(s)
Pedro Labisa, MSc1, Joana Sousa, MSc2, Pedro Cardoso, MSc2, Tomás Oliveira, MSc2.
1Takeda Oncology, Lisbon, Portugal, 2MOAI Consulting, Lisbon, Portugal.
1Takeda Oncology, Lisbon, Portugal, 2MOAI Consulting, Lisbon, Portugal.
OBJECTIVES: In Portugal, according to GLOBOCAN 2022, colorectal cancer (CRC) has the highest incidence of all cancer types and is the second leading cause of cancer-related death. CRC imposes a substantial economic burden, yet no national studies have quantified healthcare resource use in advanced metastatic settings. This study aims to estimate disease management costs for patients receiving Best Supportive Care (BSC) in late-line metastatic CRC (mCRC).
METHODS: An expert panel of five Portuguese oncologists experienced in managing mCRC provided clinical insights on healthcare resource utilization in late-line settings (4L+). Resource use, including consultations, monitoring tests and home support, was estimated through structured elicitation based on the Sheffield Elicitation Framework (SHELF) via a standardized questionnaire. Median estimates and 95% confidence intervals were calculated. Costs were derived from the national Diagnosis Related Groups (DRG) table and discounted at 4%. Progression and survival data for the Portuguese population were derived from the FRESCO-2 trial.
RESULTS: Based on expert report, before disease progression, patients receive one oncology consultation and laboratory panel every three weeks, a monthly nurse consultation and carcinoembryonic antigen (CEA) test, and one annual computed tomography (CT) scan. After disease progression, oncology consultations decrease to once every eight months, and patients begin receiving monthly palliative care consultations and ten monthly nursing home visits. Terminal care was estimated at €4,064. The median cost per patient in the late-line setting was €890 (Range:836-920, 95%CI) before progression (2.2 months) and €6,531 (Range:6137-6983, 95%CI) after progression (6.7 months), amounting to a total cost of €7,421 (Range:6973-7903, 95%CI) for patients with late-line mCRC.
CONCLUSIONS: Patients with late-line mCRC represent a significant cost to the Portuguese national health system, particularly those treated with BSC, reserved for when all therapeutic options have failed. These findings underscore the need for available therapies that delay disease progression and potentially reduce overall disease management costs.
METHODS: An expert panel of five Portuguese oncologists experienced in managing mCRC provided clinical insights on healthcare resource utilization in late-line settings (4L+). Resource use, including consultations, monitoring tests and home support, was estimated through structured elicitation based on the Sheffield Elicitation Framework (SHELF) via a standardized questionnaire. Median estimates and 95% confidence intervals were calculated. Costs were derived from the national Diagnosis Related Groups (DRG) table and discounted at 4%. Progression and survival data for the Portuguese population were derived from the FRESCO-2 trial.
RESULTS: Based on expert report, before disease progression, patients receive one oncology consultation and laboratory panel every three weeks, a monthly nurse consultation and carcinoembryonic antigen (CEA) test, and one annual computed tomography (CT) scan. After disease progression, oncology consultations decrease to once every eight months, and patients begin receiving monthly palliative care consultations and ten monthly nursing home visits. Terminal care was estimated at €4,064. The median cost per patient in the late-line setting was €890 (Range:836-920, 95%CI) before progression (2.2 months) and €6,531 (Range:6137-6983, 95%CI) after progression (6.7 months), amounting to a total cost of €7,421 (Range:6973-7903, 95%CI) for patients with late-line mCRC.
CONCLUSIONS: Patients with late-line mCRC represent a significant cost to the Portuguese national health system, particularly those treated with BSC, reserved for when all therapeutic options have failed. These findings underscore the need for available therapies that delay disease progression and potentially reduce overall disease management costs.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE337
Topic
Economic Evaluation, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology