Cost Effectiveness of Bevacizumab Plus Chemotherapy for the Treatment of Advanced and Metastatic Cervical Cancer in India—A Model-Based Economic Analysis | Zendy

Nidhi Gupta | Zendy; Prerika Nehra | Zendy; Akashdeep Singh Chauhan | Zendy; Nikita Mehra | Zendy; Ashish Singh | Zendy; Manjunath Nookala Krishnamurthy | Zendy; Kavitha Rajsekhar | Zendy; Jayachandran Perumal Kalaiyarasi | Zendy; Partha Roy | Zendy; Prabhat Singh Malik | Zendy; Anisha Mathew | Zendy; Pankaj Malhotra | Zendy; Amal Chandra Kataki | Zendy; Jyoti Dixit | Zendy; Sudeep Gupta | Zendy; Lalit Kumar | Zendy; Shankar Prinja | Zendy

Open Access

Cost Effectiveness of Bevacizumab Plus Chemotherapy for the Treatment of Advanced and Metastatic Cervical Cancer in India—A Model-Based Economic Analysis

Author(s) -

Nidhi Gupta,

Prerika Nehra,

Akashdeep Singh Chauhan,

Nikita Mehra,

Ashish Singh,

Manjunath Nookala Krishnamurthy,

Kavitha Rajsekhar,

Jayachandran Perumal Kalaiyarasi,

Partha Roy,

Prabhat Singh Malik,

Anisha Mathew,

Pankaj Malhotra,

Amal Chandra Kataki,

Jyoti Dixit,

Sudeep Gupta,

Lalit Kumar,

Shankar Prinja

Publication year - 2022

Publication title -

jco global oncology

Language(s) - English

Resource type - Journals

ISSN - 2687-8941

DOI - 10.1200/go.21.00355

Subject(s) - bevacizumab , medicine , cervical cancer , oncology , quality adjusted life year , regimen , cost effectiveness , chemotherapy , cost effectiveness analysis , cancer , surgery , risk analysis (engineering)

PURPOSE Patients with advanced and metastatic cervical cancer have a poor prognosis with a 1-year survival rate of 10%-15%. Recently, an antiangiogenic humanized monoclonal antibody bevacizumab has shown to improve the survival of these patients. This study was designed to assess the cost effectiveness of incorporating bevacizumab with standard chemotherapy for the treatment of patients with advanced and metastatic cervical cancer in India.METHODS Using a disaggregated societal perspective and lifetime horizon, a Markov model was developed for estimating the costs and health outcomes in a hypothetical cohort of 1,000 patients with advanced and metastatic cervical cancer treated with either standard chemotherapy alone or in combination with bevacizumab. Effectiveness data for each of the treatment regimen were assessed using estimates from Gynecologic Oncology Group 240 trial. Data on disease-specific mortality in metastatic cervical cancer, health system cost, and out-of-pocket expenditure were derived from Indian literature. Multivariable probabilistic sensitivity analysis was undertaken to account for parameter uncertainty.RESULTS Over the lifetime of one patient with advanced and metastatic cervical cancer, bevacizumab along with standard chemotherapy results in a gain of 0.275 (0.052-0.469) life-years (LY) and 0.129 (0.032-0.218) quality-adjusted life-years (QALY), at an additional cost of $3,816 US dollars (USD; 2,513-5,571) compared with standard chemotherapy alone. This resulted in an incremental cost of $19,080 USD (7,230-52,434) per LY gained and $34,744 USD (15,782-94,914) per QALY gained with the use of bevacizumab plus standard chemotherapy.CONCLUSION Addition of bevacizumab to the standard chemotherapy is not cost effective for the treatment of advanced and metastatic cervical cancer in India at a threshold of 1-time per-capita gross domestic product.

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