COST-UTILITY OF SOX WITH BEVACIZUMAB IN COLORECTAL CANCER AMONG INDIAN POPULATION
Author(s)
Arathi Viswam, PharmD1, Shruthi Ashok Kumar, PharmD2, Norah Elsa Shynu, PharmD2, Anna Ankita, PharmD3, Adusumilli Pramod Kumar, phD3.
1Student, M S Ramaiah University Of Applied Sciences, Bangalore, India, 2M S Ramaiah University Of Applied Sciences, Bengaluru, India, 3M S Ramaiah University Of Applied Sciences, Bangalore, India.
1Student, M S Ramaiah University Of Applied Sciences, Bangalore, India, 2M S Ramaiah University Of Applied Sciences, Bengaluru, India, 3M S Ramaiah University Of Applied Sciences, Bangalore, India.
OBJECTIVES: To evaluate the cost-effectiveness of SOX plus Bevacizumab compared with SOX plus Cetuximab in colorectal cancer patients in India, by quantifying incremental costs and quality-adjusted life years (QALYs) to determine whether the survival benefits justify the additional financial burden in a resource constrained healthcare setting.
METHODS: A cohort‑based Markov model was constructed to simulate colorectal cancer progression over a 10 year horizon with 3 week cycles (170 cycles). Strategies compared were SOX plus Bevacizumab and SOX plus Cetuximab. Transition probabilities were derived from published clinical trial data and adapted to reflect real‑world practice. Costs and utility values were sourced from peer‑reviewed literature and adjusted to the Indian payer perspective. All costs were expressed in Indian Rupees (INR), converted to Euros for international benchmarking, and discounted at 3% annually. Probabilistic sensitivity analysis was performed and willingness‑to‑pay threshold of INR 1,50,000 (~€1,396.99) per QALY gained.
RESULTS: SOX plus Bevacizumab yielded 1.5749 QALYs at a cost of ₹2,359,775 (≈ €21,981.26), while SOX plus Cetuximab yielded 1.1425 QALYs at ₹1,746,254 (≈ €16,265.26). Incremental analysis showed an additional cost of ₹613,521 (≈ €5,713.87) with a QALY gain of 0.432. The ICER was ₹1,418,977 (≈ €13,215.28) per QALY gained, exceeding conventional willingness‑to‑pay thresholds.
CONCLUSIONS: SOX plus Bevacizumab improves patient outcomes compared to SOX plus Cetuximab but at significantly higher costs in India. These findings highlights regimen is unlikely to be considered cost‑effective.
METHODS: A cohort‑based Markov model was constructed to simulate colorectal cancer progression over a 10 year horizon with 3 week cycles (170 cycles). Strategies compared were SOX plus Bevacizumab and SOX plus Cetuximab. Transition probabilities were derived from published clinical trial data and adapted to reflect real‑world practice. Costs and utility values were sourced from peer‑reviewed literature and adjusted to the Indian payer perspective. All costs were expressed in Indian Rupees (INR), converted to Euros for international benchmarking, and discounted at 3% annually. Probabilistic sensitivity analysis was performed and willingness‑to‑pay threshold of INR 1,50,000 (~€1,396.99) per QALY gained.
RESULTS: SOX plus Bevacizumab yielded 1.5749 QALYs at a cost of ₹2,359,775 (≈ €21,981.26), while SOX plus Cetuximab yielded 1.1425 QALYs at ₹1,746,254 (≈ €16,265.26). Incremental analysis showed an additional cost of ₹613,521 (≈ €5,713.87) with a QALY gain of 0.432. The ICER was ₹1,418,977 (≈ €13,215.28) per QALY gained, exceeding conventional willingness‑to‑pay thresholds.
CONCLUSIONS: SOX plus Bevacizumab improves patient outcomes compared to SOX plus Cetuximab but at significantly higher costs in India. These findings highlights regimen is unlikely to be considered cost‑effective.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE372
Topic
Economic Evaluation, Health Technology Assessment, Methodological & Statistical Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology, Personalized & Precision Medicine