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Title
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Cost-effectiveness of molecular profile patient selection for first-line treatment of recurrent/metastatic head and neck cancer
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Author
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Abstract
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| Purpose: Patients with recurrent and/or metastatic head and neck squamous cell cancer are offered platinum-based chemotherapy plus cetuximab; however, this strategy is not cost-effective. We evaluated the cost-effectiveness of a hypothetical predictive molecular test to identify and treat only patients potentially responsive to cetuximab (C) added to platinum-fluorouracil (PF) (PF + C POS) versus the administration of PF + C to all patients (PF + C ALL). Methods: A Markov model has been developed to estimate health outcomes (quality-adjusted life years [QALYs]; life years [LYs]) and costs of the 2 strategies on a time horizon of 3 years from the Italian health care perspective. For the response to treatment, a definition, including partial or complete response, has been applied. In the base-case scenario, molecular test sensitivity, specificity, and cost have been assumed equal to 85%, 70%, and is an element of 4000, respectively. Findings: The model estimated 0.5285 QALYs (0.9245 LYs) and 0.5666 QALYs (0.9949 LYs) for PF + C POS and PF + C ALL, respectively. The incremental cost-utility ratio of PF + C ALL versus PF + C POS was is an element of 112,462/QALY, suggesting the administration of PF + C only to patients who would be responsive to it. (C) 2019 Elsevier Inc. All rights reserved. |
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Language
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English
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Source (journal)
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Clinical therapeutics. - Princeton, N.J.
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Publication
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Princeton, N.J.
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2019
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ISSN
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0149-2918
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DOI
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10.1016/J.CLINTHERA.2019.09.015
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Volume/pages
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41
:12
(2019)
, p. 2517-2528
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ISI
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000505107100007
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Pubmed ID
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31630814
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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