title: Five-year survival and costs of care in metastatic colorectal cancer: conventional versus monoclonal antibody-based treatment protocols.
abstract: OBJECTIVE
  To evaluate the costs and survival estimates of metastatic colorectal carcinoma patients treated with conventional cytostatic protocols and adjuvant monoclonal antibodies (mAbs).
  
  
  METHODS
  Retrospective randomized case series and cost-of-illness analysis was used. Metastatic colorectal carcinoma cases (62) were randomly selected from the archive of the largest university military hospital in Southeastern Europe.
  
  
  RESULTS
  A 6-month longer survival was attributed to mAbs (p = 0.581). Conventional protocols incurred € 5137 (95% CI: € 3758-€ 6517) versus € 22,113 (95% CI: € 16,201-€ 28,025) total direct medical costs in mAb-based group. ICER of € 32,108 per life year gained attributable to mAbs three-fold exceeded informal willingness to pay threshold of Serbia.
  
  
  CONCLUSIONS
  mAbs adjuvant protocols had modest positive impact on 5-year survival rates. Costs were driven by targeted biologicals, but significantly higher costs of care were recorded in mAb-treated group in other domains, as well. More selective prescription and reimbursement criteria should be applied to increase cost-effectiveness of targeted oncology agents.
authors.affiliation: Centre for Clinical Pharmacology, Military Medical Academy Medical Faculty, University of Defense, Belgrade, Serbia, Europe.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kovacevic
authors.forename: Viktorija
authors.initials: V
authors.lastname: Dragojevic-Simic
authors.forename: Dino
authors.initials: D
authors.lastname: Tarabar
authors.forename: Nemanja
authors.initials: N
authors.lastname: Rancic
authors.forename: Nemanja
authors.initials: N
authors.lastname: Jacimovic
authors.forename: Jelena
authors.initials: J
authors.lastname: Katic
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Dagovic
authors.forename: Mihajlo
authors.initials: M
authors.lastname: Jakovljevic
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000473:pathology; D003362:Cost-Benefit Analysis; D005260:Female; D006772:Hospitals, Military; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D055771:Serbia; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal
keywords: cancer; colorectal carcinoma; costs; economics; long term; monoclonal antibodies; survival