Naslov
BIA result could stop introduction of cost-effectiveness therapy into standard treatment: advanced head and neck carcinoma in Croatia

Autori
Culig, Josip ; Leppee, Marcel ; Vrca, Vesna

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
ISPOR 14th Annual European Congress ; abstract: Value in Health 2011 ; 14:A469 / - , 2011

Skup
ISPOR 14th Annual European Congress

Mjesto i datum
Madrid, Španjolska, 05.11.2011. - 08.11.2011

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
cost-effectiveness; therapy; head and neck carcinoma

Sažetak
In order for a new therapy to be included on the basic list of treatments covered by Croatian lnstitute for Health lnsurance (and this means a full reimbursement of costs), it must prove to have a positive effect on the budget. An analysis of cost-effectiveness is not mandatory. The standard therapy for patients suffering from advanced head and neck cancer is chemoradiotherapy (mainly platinum and radiation therapy). However, if chemotherapy proves to be contraindicative, only standard radiation is applied. Cetuximab inhibits EGFR, which stops the mechanism of signalization and induces the apoptosis of cancer cells. lt has been proven that the implementation of immunoradiotherapy contributes to the overall survivalof patients, as wellas to a better locoregional control of the illness. Methods Known costs of the standard therapy for advanced head and neck cancer were compared with the costs of the proposed new therapy (cetuximab+radiotherapy) for the period of three consecutive calendar years. The costs are shown in the Croatian currency (HRK) ; (1 Euro=7, 4 HRK). The increased costs of immunotherapy are compared to the data on efficiency from published literature. Results Approximately 212 patients with advanced head and neck cancer receive treatment in Croatia every year. The treatment mostly consists of chemoradiotherapy (platinum + radiotherapy). If chemotherapy proves to be contra-indicative, a standard radiotherapy is applied (around 42 patients a year). The Croatian Institute for Health Insurance (HZZO) spends 840.000, 00 HRK a year on the treatment of those patients (the cost of radiatiotherapy for one patient is 20.000, 00 HRK). The inclusion of cetuximab into the standard therapy would increase the total yearly costs of HZZO by 3, 082.650, 90 HRK. When compared to radiatio therapy, immunoradiotherapy prolongs the loco-regional control of the illness (14, 9 vs. 24, 4 months on average), as 50 Pregled 2011./2012. well as the overall survival of patients (29, 3 vs. 49, 0 months on average). The cost for one added life-year per patient, with included immunotherapy, would be approximately 89.738, 00 HRK. Conclusion The inclusion of immunotherapy into the standard treatment of patients with advanced head and neck cancer would have a negative impact on the budget of the Croatian Institute for Health Insurance. The average costs for one added life-year (89.738, 00 HRK) are lower than the average costs of hemodialysis in patients who suffer from chronic kidney insufficiency (150.000, 00 HRK). Despite the negative results of BIA (budget impact analysis), cetuximab should be included into standard patient treatment of the advanced head and neck cancer.

Izvorni jezik
Engleski

Znanstvena područja
Javno zdravstvo i zdravstvena zaštita

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