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Cost of chemotherapy for metastatic colorectal cancer with either bevacizumab or cetuximab: Economic analysis of CALGB/SWOG 80405.

2015· article· en· W2755539625 on OpenAlexaff
Deborah Schrag, Amylou C. Dueck, Michelle J. Naughton, Donna Niedzwiecki, Craig C. Earle, James E. Shaw, Axel Grothey, Howard S. Höchster, Charles D. Blanke, Alan P. Venook

Bibliographic record

VenueJournal of Clinical Oncology · 2015
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicEconomic and Financial Impacts of Cancer
Canadian institutionsInstitute for Clinical Evaluative Sciences
Fundersnot available
KeywordsMedicineCetuximabBevacizumabIrinotecanOncologyColorectal cancerOxaliplatinInternal medicineChemotherapyKRASPemetrexedCancerCisplatin

Abstract

fetched live from OpenAlex

6504 Background: CALGB/SWOG 80405, a phase III trial, found that adding either bevacizumab or cetuximab to standard first-line chemotherapy for metastatic colorectal cancer (mCRC) resulted in similar survival. We compared the economics of treatment on each arm. Methods: Patients were assigned to standard chemotherapy (Cx) and randomized to either bevacizumab (B, N = 559) or cetuximab (C, N = 578).Quality of life was assessed at baseline and at 8 week intervals using the EQ5D on a representative subgroup of participants (N = 56 for B and N = 55 for C) to estimate utilities. Because survival and quality of life were similar in each arm, cost-minimization rather than cost-effectiveness analysis was performed. Chemotherapy utilization was tracked from randomization to progression and drug costs were estimated using 4thquarter 2014 average sales price from the US Center for Medicare and Medicaid Services. Resource utilization of acute care including hospitalizations, emergency room visits and ICU care were tracked while patients were on study and costs assigned based on CMS estimates for mCRC patients. End of life and downstream costs were assumed to be comparable per survival month. Out of pocket costs were not tracked. All cost estimates are in 2014 USD. Results: Acute care costs were similar but drug costs were higher in the cetuximab arm (Table). Results were robust to sensitivity analyses and did not change whether the chemotherapy backbone included oxaliplatin or irinotecan. Conclusions: For first-line chemotherapy treatment of patients with kras wild type mCRC, based on US 2014 drug costs, bevacizumab is preferable to cetuximab from a health economic standpoint. Clinical trial information: NCT00265850. Mean Costs of treatment for participants in CALGB 80405 Chemo+B N=559 Chemo+C N=578 Difference (95% CI) Protocol-directed chemotherapy Acute care on study Chemo and acute care costs $37,124 $28,951 $66,076 $75,845 $29,494 $105,339 $-38,720 (-45,699 to -31,740) $-543 (-2831 to +1,745) $-39,264 (-46,521 to -32,005)

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.410
Threshold uncertainty score0.685

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0040.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0040.001
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.241
GPT teacher head0.451
Teacher spread0.210 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations17
Published2015
Admission routes1
Has abstractyes

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