Elsisi Gihan, Abdul Kareem Hana, Alaseiri Abdelaziz, Alsharm Abdullah, Al Garni Mohamed, Al-Mudaiheem Hajer, Alnagar Fouad, Lotfy Hazem, Ouda Mohamed, Elshehri Ahmed
HTA Office, LLC, Cairo, Egypt.
Economics Department American University in Cairo, Egypt.
J Health Econ Outcomes Res. 2025 Mar 7;12(1):106-112. doi: 10.36469/001c.130878. eCollection 2025.
In Saudi Arabia, patients with metastatic colorectal cancer (mCRC) with wild-type RAS mutations may be treated with either cetuximab plus chemotherapy (CET + CT) or panitumumab plus chemotherapy (PAN + CT), which are epidermal growth factor receptor (EGFR) antibodies. This study calculated the costs of adverse event (AE) management linked to anti-EGFR treatment in Saudi Arabia's national health budget from payer and societal perspectives. An adaptation of a global model developed in Microsoft Excel® was performed to estimate the costs of AE management associated with the first-line treatment (CET + CT and PAN + CT) of RAS wild-type mCRC patients in Saudi healthcare settings. The frequencies of common and highly common AEs were sourced from the summaries of product characteristics of CET and PAN, whereas AE severity was captured from a meta-analysis. Unit costs in Saudi Riyal (SAR) were obtained from the National Guard of Health Affairs and Ministry of Health 2024 price lists. The model assumptions, inputs, and results were validated using a local Delphi panel. Within the Saudi payer perspective model, treatment with CET + CT vs PAN + CT resulted in average population cost savings of SAR 9 246 133 (4 741 606 international dollars [Intl 10 421) for severe AEs, and average population cost savings of SAR 16 039 427 (Intl 18 077) for all-grade AEs. On the other hand, within the Saudi societal perspective model, treatment with CET + CT vs PAN + CT resulted in average population cost savings of SAR 11 386 314 (Intl 12 833) for severe AEs, while resulting in average population cost savings of SAR 18 179 608 (Intl 20 489) for all grade AEs. The CET + CT regimen was associated with a lower AE frequency than the PAN + CT regimen for the treatment of untreated RAS wild-type mCRC patients, thus resulting in AE management cost savings from both the Saudi payer and societal perspectives. These substantial cost savings may mitigate the financial burden of mCRC in Saudi healthcare settings.
在沙特阿拉伯,具有野生型RAS突变的转移性结直肠癌(mCRC)患者可以接受西妥昔单抗联合化疗(CET + CT)或帕尼单抗联合化疗(PAN + CT)治疗,这两种都是表皮生长因子受体(EGFR)抗体。本研究从支付方和社会角度计算了沙特阿拉伯国家卫生预算中与抗EGFR治疗相关的不良事件(AE)管理成本。对在Microsoft Excel®中开发的全球模型进行了调整,以估计沙特医疗环境中RAS野生型mCRC患者一线治疗(CET + CT和PAN + CT)相关的AE管理成本。常见和高度常见AE的发生率来自CET和PAN的产品特征摘要,而AE严重程度则从一项荟萃分析中获取。沙特里亚尔(SAR)的单位成本来自国民警卫队卫生事务部和卫生部2024年价格表。使用当地的德尔菲小组对模型假设、输入和结果进行了验证。在沙特支付方视角模型中,与PAN + CT相比,CET + CT治疗导致严重AE的平均人群成本节省9246133沙特里亚尔(4741606国际美元[Intl 10421]),所有级别的AE平均人群成本节省16039427沙特里亚尔(Intl 18077)。另一方面,在沙特社会视角模型中,与PAN + CT相比,CET + CT治疗导致严重AE的平均人群成本节省11386314沙特里亚尔(Intl 12833),而所有级别的AE平均人群成本节省18179608沙特里亚尔(Intl 20489)。对于未治疗的RAS野生型mCRC患者的治疗,CET + CT方案的AE发生率低于PAN + CT方案,因此从沙特支付方和社会角度来看,都节省了AE管理成本。这些大幅成本节省可能会减轻沙特医疗环境中mCRC的经济负担。