TY - JOUR
T1 - Economic Evaluation of Adding Bevacizumab to Chemotherapy for Metastatic Colorectal Cancer (mCRC) Patients in Indonesia
AU - Kristin, Erna
AU - Endarti, Dwi
AU - Khoe, Levina Chandra
AU - Taroeno-Hariadi, Kartika Widayati
AU - Trijayanti, Christina
AU - Armansyah, Armansyah
AU - Sastroasmoro, Sudigdo
N1 - Funding Information:
Above all, we thank the patients who participated in this study and the staff at Dharmais Hospital, Bethesda Hospital, Sardjito Hospital, and Sanglah Hospital for providing the data. We appreciate the support and guidance from the Center of Financing and Health Insurance, Ministry of Health, Government of Indonesia and Indonesia Health Technology Assessment Committee throughout the study. We are also grateful to National Health Insurance Agency for sharing the data with us.
Funding Information:
This work was supported by National Health Insurance Agency (BPJS Kesehatan) as part of Health Technology Assessment study under the Center of Financing and Health Insurance (PPJK), Ministry of Health, Government of Indonesia.
Publisher Copyright:
© 2021. All Rights Reserved.
PY - 2021/6
Y1 - 2021/6
N2 - Objective: Since 2016, bevacizumab has been widely used to treat metastatic colorectal cancer (mCRC) in Indonesia. Nevertheless, the high cost of bevacizumab has raised the question of whether the therapy is considered cost-effective and should be included in the national health insurance system. This study aimed to assess the cost-effectiveness of bevacizumab plus chemotherapy versus chemotherapy alone for the treatment of mCRC patients. Methods: A Markov model was applied using the perspective of the Indonesian healthcare system to assess cost-effectiveness. The health outcomes were expressed in terms of quality-adjusted life years (QALY) using the validated EuroQoL-5D-5L instrument. Data for medical costs were collected from hospital billings in four hospitals located in three different cities in Indonesia. Meanwhile, data for utility were obtained from interviewing 90 patients who came to the hospital. We compared those mCRC patients who received chemotherapy alone either with FOLFOX or FOLFIRI, versus patients who received the addition of bevacizumab. Results: With the perspective of societal, the incremental cost-effectiveness ratio (ICER) of adding bevacizumab was USD 49,312 per QALY gained using secondary data and USD 28,446 per QALY using real world data. Conclusion: Using either a healthcare or societal perspective, the addition of bevacizumab for mCRC treatment was considered not cost-effective.
AB - Objective: Since 2016, bevacizumab has been widely used to treat metastatic colorectal cancer (mCRC) in Indonesia. Nevertheless, the high cost of bevacizumab has raised the question of whether the therapy is considered cost-effective and should be included in the national health insurance system. This study aimed to assess the cost-effectiveness of bevacizumab plus chemotherapy versus chemotherapy alone for the treatment of mCRC patients. Methods: A Markov model was applied using the perspective of the Indonesian healthcare system to assess cost-effectiveness. The health outcomes were expressed in terms of quality-adjusted life years (QALY) using the validated EuroQoL-5D-5L instrument. Data for medical costs were collected from hospital billings in four hospitals located in three different cities in Indonesia. Meanwhile, data for utility were obtained from interviewing 90 patients who came to the hospital. We compared those mCRC patients who received chemotherapy alone either with FOLFOX or FOLFIRI, versus patients who received the addition of bevacizumab. Results: With the perspective of societal, the incremental cost-effectiveness ratio (ICER) of adding bevacizumab was USD 49,312 per QALY gained using secondary data and USD 28,446 per QALY using real world data. Conclusion: Using either a healthcare or societal perspective, the addition of bevacizumab for mCRC treatment was considered not cost-effective.
KW - Metastatic colorectal cancer- bevacizumab- chemotherapy
UR - http://www.scopus.com/inward/record.url?scp=85109162811&partnerID=8YFLogxK
U2 - 10.31557/APJCP.2021.22.6.1921
DO - 10.31557/APJCP.2021.22.6.1921
M3 - Article
C2 - 34181352
AN - SCOPUS:85109162811
VL - 22
SP - 1921
EP - 1926
JO - Asian Pacific Journal of Cancer Prevention
JF - Asian Pacific Journal of Cancer Prevention
SN - 1513-7368
IS - 6
ER -