Cost Impact of Bevacizumab and Cetuximab Associated Therapies in Colorectal Cancer in Veneto Region

Objective: To assess the economic impact of the introduction of bevacizumab and cetuximab, in 1st and 2nd line treatment of mCRC patients in Veneto region (North-East of Italy). Methods: A Markov state decision model was implemented to evaluate the cost impact of bevacizumab and cetuximab use in patients with mCRC for a lapse of time of three years in Veneto public hospitals. The Markov model expressed transition probabilities from three different states, comparing in addition the expected deaths and the monthly survival rates in treatment and no-treatment groups, along the lines of previously published studies. Results: The cost impact of bevacizumab administration in patients with mCRC accounted a mean value of 18268788 € within the first 6 months. Cetuximab therapy for those refractory to 1^st line treatment, increased costs of almost 833340 € in the first 6 months, increasing in the following period due to a higher portion of patients switching from a stable status to a progressive one. Discussion: The cost impact of monoclonal antibodies on health expenses is very high. For a regional cohort like the Veneto's one, figure sets around 19000000 € in 6 months, when considering 1^st and 2^nd line treatment, reaching the level of 50000000 € within three years.