AN ECONOMIC MODEL OF CATUMAXOMAB FOR MALIGNANT ASCITES IN ENGLAND
Author(s)
Edward Andrew Griffin, MSc1, Jennifer Knight, PhD2, Emillia Pierson, BSc, MSc3, Annie Barnes, PhD2, Michael Withe, BSc4.
1EGCL (Independent UK HTA Economics), Newton Abbot, United Kingdom, 2AXIS - The Reimbursement Experts, Manchester, United Kingdom, 3Pharmanovia, Basildon, United Kingdom, 4Pharmanovia, Hatfield, United Kingdom.
1EGCL (Independent UK HTA Economics), Newton Abbot, United Kingdom, 2AXIS - The Reimbursement Experts, Manchester, United Kingdom, 3Pharmanovia, Basildon, United Kingdom, 4Pharmanovia, Hatfield, United Kingdom.
OBJECTIVES: Catumaxomab (Korjuny®) is a tri-specific antibody indicated for the intraperitoneal treatment of malignant ascites in adults with EpCAM-positive carcinomas who are no longer eligible for further systemic anti-cancer therapy. Catumaxomab is administered using a temporary indwelling peritoneal catheter as a single 10-day course of four intraperitoneal infusions. The pivotal AC-01 randomised controlled trial for catumaxomab versus large-volume paracentesis showed statistically significant puncture-free survival, a trend of improved survival, and significant reduction in symptom burden.
METHODS: A cost-effectiveness model of catumaxomab versus large-volume paracentesis was developed, examining QALY and 2025 cost differences. Subsequent permanent catheterisation was factored into both strategies in 10% of cases. To capture improvements in wellbeing, overall survival was partitioned into Stable and Deteriorating health states by smoothed, extrapolated, mortality-adjusted Kaplan-Meier plots of time-to-first-deterioration in quality-of-life. Utility for Stable was the treatment-specific mean of up to three patient datapoints before any evidence of deterioration - prior to first therapeutic puncture or death. Utilities for four Deterioration sub-states were the non-treatment specific means of datapoints from the moment of downturn, taking account of proximity to death. Near complete PuFS and OS outcomes were smoothed and extrapolated using standard survival analysis. Timing of punctures subsequent to the first therapeutic puncture informed their frequency and consequent number - providing a pattern of diminishing puncture delay. First administration of catumaxomab used the inpatient setting, then either daycase or outpatient. Large-volume paracentesis procedures were 80% inpatient, and 20% outpatient. Permanent catheters were placed as daycase, with community-assisted drainage thereafter.
RESULTS: The catumaxomab strategy compared to large-volume paracentesis gained 0.124 life-years, and 0.182 QALYs - including a x1.7 disease severity modifier - at a cost of £5,765.
CONCLUSIONS: The resultant incremental cost-effectiveness ratio (ICER) was £31,693 per QALY gained demonstrates that catumaxomab is a cost-effective option for the treatment of malignant ascites at typical value thresholds
METHODS: A cost-effectiveness model of catumaxomab versus large-volume paracentesis was developed, examining QALY and 2025 cost differences. Subsequent permanent catheterisation was factored into both strategies in 10% of cases. To capture improvements in wellbeing, overall survival was partitioned into Stable and Deteriorating health states by smoothed, extrapolated, mortality-adjusted Kaplan-Meier plots of time-to-first-deterioration in quality-of-life. Utility for Stable was the treatment-specific mean of up to three patient datapoints before any evidence of deterioration - prior to first therapeutic puncture or death. Utilities for four Deterioration sub-states were the non-treatment specific means of datapoints from the moment of downturn, taking account of proximity to death. Near complete PuFS and OS outcomes were smoothed and extrapolated using standard survival analysis. Timing of punctures subsequent to the first therapeutic puncture informed their frequency and consequent number - providing a pattern of diminishing puncture delay. First administration of catumaxomab used the inpatient setting, then either daycase or outpatient. Large-volume paracentesis procedures were 80% inpatient, and 20% outpatient. Permanent catheters were placed as daycase, with community-assisted drainage thereafter.
RESULTS: The catumaxomab strategy compared to large-volume paracentesis gained 0.124 life-years, and 0.182 QALYs - including a x1.7 disease severity modifier - at a cost of £5,765.
CONCLUSIONS: The resultant incremental cost-effectiveness ratio (ICER) was £31,693 per QALY gained demonstrates that catumaxomab is a cost-effective option for the treatment of malignant ascites at typical value thresholds
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE216
Topic
Economic Evaluation
Topic Subcategory
Trial-Based Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology