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Abstract

Aim: To compare healthcare resource utilization (HRU) and healthcare costs (HC) for every-2-week (Q2W) versus weekly (Q1W) cetuximab in metastatic colorectal cancer (mCRC). Patients & methods: Patients with mCRC receiving cetuximab plus chemotherapy in a line-agnostic setting. Cohort study of patients with mCRC treated with cetuximab and chemotherapy in IBM MarketScan. Analyses were weighted by inverse probability of treatment based on propensity score. Results: HRU was numerically lower with the Q2W versus Q1W regimen (weighted mean, 8.1 vs 9.5 encounters per-patient-per-month). The weighted average of HC was $17,653 and $16,469 per-patient-per-month for the Q2W and Q1W regimens, respectively; the difference between regimens decreased when restricting to CRC-related claims. Conclusion: HRU was lower and HC were similar between the Q2W and Q1W regimens.

Supplementary Material

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References

Papers of special note have been highlighted as: • of interest
1.
American Cancer Society. Key statistics for colorectal cancer (2020). www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html
2.
Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat. Rev. Gastroenterol. Hepatol. 16(12), 713–732 (2019).
3.
Siegel RL, Miller KD, Goding Sauer A et al. Colorectal cancer statistics, 2020. CA Cancer J. Clin. 70(3), 145–164 (2020).
4.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Colon Cancer. Version 4. 2020. www.nccn.org/professionals/physician_gls/pdf/colon.pdf
5.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer. Version 6. 2020. www.nccn.org/professionals/physician_gls/pdf/rectal.pdf
6.
García-Foncillas J, Sunakawa Y, Aderka D et al. Distinguishing features of cetuximab and panitumumab in colorectal cancer and other solid tumors. Front. Oncol. 9, 849 (2019).
7.
Dekker E, Tanis PJ, Vleugels JLA et al. Colorectal cancer. Lancet 394(10207), 1467–1480 (2019).
8.
FDA. Erbitux (cetuximab). Prescribing information (2019). www.accessdata.fda.gov/drugsatfda_docs/label/2019/125084s273lbl.pdf
9.
Mrabti H, De la Fouchardiere C, Desseigne F et al. Irinotecan associated with cetuximab given every 2 weeks versus cetuximab weekly in metastatic colorectal cancer. J. Cancer Res. Ther. 5(4), 272–276 (2009).
10.
Yeh Y-S, Chiang C-Y, Chen C-J et al. Efficacy and safety of weekly and biweekly cetuximab-combined FOLFIRI regimen as first-line setting in patients with metastatic colorectal cancer: experience in a southern Taiwan medical center. J. Soc. Colon Rectal Surgeon (Taiwan). 21, 59–68 (2010).
11.
Brodowicz T, Ciuleanu TE, Radosavljevic D et al. FOLFOX4 plus cetuximab administered weekly or every second week in the first-line treatment of patients with KRAS wild-type metastatic colorectal cancer: a randomized phase II CECOG study. Ann. Oncol. 24(7), 1769–1777 (2013).
12.
Li J, Li J. Therapeutic effect of biweekly cetuximab combined with first-line chemotherapy on KRAS/RAS wild-type advanced colorectal cancer. Int. J. Clin. Exp. Med. 12(10), 12348–12355 (2019).
13.
Tabernero J, Pfeiffer P, Cervantes A. Administration of cetuximab every 2 weeks in the treatment of metastatic colorectal cancer: an effective, more convenient alternative to weekly administration? Oncologist 13(2), 113–119 (2008).
14.
NICE. NICE Guidance: cetuximab and panitumumab for previously untreated metastatic colorectal cancer (2017). www.nice.org.uk/Guidance/ta439
15.
Phelip JM, Tougeron D, Leonard D et al. Metastatic colorectal cancer (mCRC): French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFR). Dig. Liver Dis. 51(10), 1357–1363 (2019).
16.
Lamy F-X, Batech M, Boutmy E et al. Comparative effectiveness of weekly versus every-2-weeks cetuximab in metastatic colorectal cancer in a US insured population. J. Comp. Eff. Res. 9(16), 1117–1129 (2020).
17.
Song X, Zhao Z, Barber B et al. Characterizing medical care by disease phase in metastatic colorectal cancer. Am. J. Manag. Care. 17(Suppl. 5), SP20–SP25 (2011).
• Describes an algorithm that can be used to empirically identify and prioritize candidate covariates in order to integrate them into a propensity score-based confounder adjustment model.
18.
Paramore LC, Thomas SK, Knopf KB et al. Estimating costs of care for patients with newly diagnosed metastatic colorectal cancer. Clin. Colorectal Cancer. 6(1), 52–58 (2006).
• Describes the resource use patterns and costs of care for patients with metastatic colorectal cancer using retrospective claims data from selected US health plans.
19.
Schneeweiss S, Rassen JA, Glynn RJ et al. High-dimensional propensity score adjustment in studies of treatment effects using health care claims data. Epidemiology 20(4), 512–522 (2009).
• Describes a statistical approach that can be used to obtain appropriate estimates of variance of the main effects in regression models for the purpose of performing inverse probability of treatment weighting to reduce selection bias.
20.
Xu S, Ross C, Raebel MA et al. Use of stabilized inverse propensity scores as weights to directly estimate relative risk and its confidence intervals. Value Health 13(2), 273–277 (2010).
21.
Kasper S, Cheng A, Overkamp F et al. Noninferiority on overall survival of every-2-weeks vs weekly schedule of cetuximab for first-line treatment of RAS wild-type metastatic colorectal cancer. Ann. Oncol. 30(Suppl. 5), v198–v252 (2019).
22.
Brodowicz T, Vrbanec D, Kaczirek K et al. FOLFOX4 plus cetuximab administered weekly or every two weeks in first-line treatment of patients with KRAS and NRAS wild-type (wt) metastatic colorectal cancer (mCRC). J. Clin. Oncol. 32(Suppl. 3), LBA391 (2017).
23.
Lamy FL, Batech M, Salim S et al. Real-world study of cetuximab used every other week versus weekly in US patients with metastatic colorectal cancer (mCRC). J. Clin. Oncol. 37(Suppl. 15), e15087 (2019).