Cost-effectiveness of RAS screening before monoclonal antibodies therapy in metastatic XXXX based on FIRE3 Study.

@entity1 @entity984 @entity204 @entity14
UNASSIGNED: The surprising results published by FIRE-3 revealed that the overall survival (OS) of RAS wild-type metastatic @entity14 (mCRC) @entity1 treated with Cetuximab(Cmab) and FOLFIRI combination was prolonged to 33.1  months. The substantial increase in testing and treatment costs, however, impose a considerable health burden on @entity1 and society. Hence the study was aimed to assess the cost-effectiveness of RAS screening before monoclonal antibodies (mAbs) therapy based on FIRE-3 study. Four groups were analyzed: group 1, @entity1 with @entity984 testing treated with Cmab and FOLFIRI; group 2, @entity1 with RAS testing treated with Cmab and FOLFIRI; group 3, @entity1 with @entity984 testing treated with bevacizumab(Bmab) and FOLFIRI; group 4, @entity1 with RAS testing treated with Bmab and FOLFIRI. A Markov model comprising 3 health states (progression-free survival, progressive disease and @entity204 ) was built. The costs were calculated from a Chinese payer perspective, and survival was reported in quality-adjusted life-months (QALMs). Average total lifetime costs ranged from  104,682.44 (RAS-Bmab) to  136,867.44 (RAS-Cmab), while the survival gained varied from 16.88 QALMs in RAS-Bmab to 21.85 QALMs in RAS-Cmab. The cost per QALM was  6,263.86 for RAS-Cmab,  6,145.84 for @entity984 -Bmab,  6,201.57 for RAS-Bmab and  6,960.70 for @entity984 -Cmab respectively. The @entity984 -Cmab strategy was dominated by the other 3 groups. The first-treatment cost of RAS-Cmab was the most influential one to the model. In all, the RAS screening prior to Cmab treatment in mCRC seems to be a cost-effective strategy in the time of monoclonal antibodies (mAbs) therapy with the most gained QALMs.
