caa a22 4500 606186271 CHVBK 20210128100835.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00405-014-3106-3 doi (NATIONALLICENCE)springer-10.1007/s00405-014-3106-3 Real-world cost-effectiveness of cetuximab in locally advanced squamous cell carcinoma of the head and neck [Elektronische Daten] [N. van der Linden, C. van Gils, C. Pescott, J. Buter, M. Vergeer, C. Groot] Clinical trial EMR 62202-006 demonstrates prolonged median locoregional control (24.4 vs. 14.9months), progression-free survival (17.1 vs. 12.4months) and overall survival (49.0 vs. 29.3months) for patients who receive cetuximab added to the comparator radiotherapy for locally advanced squamous cell carcinoma of the head and neck (LA SCCHN). In the Netherlands, hospitals receive reimbursement for cetuximab conditional on cost-effectiveness in daily practice. To estimate the real-world incremental cost per quality adjusted life-year (QALY) gained for radiotherapy+cetuximab over radiotherapy alone in first line treatment of LA SCCHN, aMarkov model is constructed with health states "alive without progression”, "alive following progression” and "death”. Transition probabilities per month are estimated from clinical trial data and retrospectively collected real-world data from two Dutch head and neck cancer treatment centres (2007-2010, n=141). 5-year, 10-year and lifetime horizons are used, without and with discounting (4% costs, 1.5% effects) to calculate incremental cost-effectiveness ratios. Two scenarios explore different assumptions on prognosis of real-world versus trial patients. Adding cetuximab to radiotherapy results in increased costs and health gains in both scenarios and across each of the time horizons. Incremental costs per QALY gained range between €14,624 and €38,543 in the base-case. For a willingness to pay of €80,000 per QALY, the acceptability curves for the different scenarios show probabilities between 0.76 and 0.87 of radiotherapy+cetuximab being cost-effective compared to radiotherapy alone. Current results show the combined treatment of radiotherapy+cetuximab to be a cost-effective treatment option for patients with LA SCCHN. Springer-Verlag Berlin Heidelberg, 2014 Head and neck cancer nationallicence Outcomes nationallicence Cost-effectiveness nationallicence Epidermal growth factor receptor (EGFR) inhibitor nationallicence Chemo-radiotherapy nationallicence Radiotherapy nationallicence van der Linden N. Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands aut van Gils C. Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands aut Pescott C. Merck BV, Tupolevlaan 41-61, 1119 NW, Schiphol Rijk, The Netherlands aut Buter J. VU Medical Center (VUMC), Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands aut Vergeer M. VU Medical Center (VUMC), Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands aut Groot C. Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/8(2015-08-01), 2007-2016 0937-4477 272:8<2007 2015 272 405 https://doi.org/10.1007/s00405-014-3106-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3106-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- van der Linden N. Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Gils C. Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Pescott C. Merck BV, Tupolevlaan 41-61, 1119 NW, Schiphol Rijk, The Netherlands aut NATIONALLICENCE 700 1- Buter J. VU Medical Center (VUMC), Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Vergeer M. VU Medical Center (VUMC), Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Groot C. Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/8(2015-08-01), 2007-2016 0937-4477 272:8<2007 2015 272 405