OBJECTIVES: The EGFR antibodies cetuximab and panitumumab are reimbursed in the Czech Republic in combination with chemotherapy or alone for the treatment of WT RAS patients with metastatic colorectal cancer (mCRC). However, the high cost is a potentially limiting factor. The aim of this analysis was comparison of costs in treatment with cetuximab or panitumumab in the first-line treatment of mCRC.

METHODS: The costs and effectiveness of cetuximab and panitumumab in the real clinical practice were retrospectively evaluated in the National comprehensive cancer center from the perspective of healthcare payer. Cost data (examination, medication, hospitalization) were collected since the initiation of cetuximab/panitumumab treatment to any tumour response (RECIST criteria) and/or to death. Mean follow-up was 21 and 17 months for all patients treated with cetuximab and panitumumab respectively. Costs were converted to EUR (€1= CZK 26.23).

RESULTS: In total 22 (73%men, mean age 60) and 29 (66%men, mean age 58) WT KRAS patients with mCRC were treated with cetuximab and panitumumab in the first-line treatment between 11/2011 and 07/2016. The treatment was mostly discontinued in both evaluated groups due to PD (cetuximab 59.1%; panitumumab 55.2%). The mean costs per progression-free survival (median 10.7 and 8.1 months) were EUR 36,762.7 and EUR 38,247.4 (CZK 964,286.80 and CZK 1,003,229.13) for cetuximab and panitumumab respectively. During our follow-up period 55% patients died in cetuximab group; 41% patients in panitumumab group. The median overall survival was 17.3 and 12.1 months and the mean costs since initiation of treatment to death were EUR 48,978.7 and EUR 48.977.7 (CZK 1,284,712.1 and CZK 1,284,685.1) per patient treated with cetuximab and panitumumab respectively.

CONCLUSIONS: The reimbursement of EGFR antibodies were the main cost driver observed in both evaluated groups. Drugs made up more than 71% (cetuximab) and 77% (panitumumab) of total costs to PD.