Background The escalating economic burden of metastatic colorectal cancer (mCRC) in China necessitates cost-effective first-line treatments. Cetuximab-β, a newer version of Cetuximab, is approved for first-line RAS/BRAF wild-type mCRC. This study evaluates the cost-effectiveness of Cetuximab-β with FOLFIRI for mCRC patients, comparing it to Cetuximab plus chemotherapy to guide clinical decision-making and policy development. Methods We conducted a network meta-analysis (NMA) of six randomized controlled trials to compare overall survival (OS), progression-free survival (PFS), and adverse events (AEs). Subsequently, a cost-effectiveness analysis (CEA) was performed using a 10-year partitioned survival model from the Chinese healthcare payer perspective. Costs were standardized to 2024 US dollars (1 = ¥7. 25). Both costs and outcomes were discounted annually at 5%. The model estimated life-years (LYs), quality-adjusted life-years (QALYs), total costs, and incremental cost-effectiveness ratios (ICER). Model uncertainty was evaluated via one-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analyses. Results The NMA showed comparable efficacy between Cetuximab-β and Cetuximab, with Cetuximab demonstrating an OS HR of 1. 10 (95% CI 0. 67–1. 90) and a PFS HR of 0. 94 (95% CI 0. 49–1. 80) compared with Cetuximab-β, along with a trend towards a more favorable safety profile for Cetuximab-β. CEA showed Cetuximab-β reduced costs by 12, 005. 54 (34, 996. 43 vs. 47, 001. 97) and gained 0. 10 QALYs (1. 90 vs. 1. 80 QALYs) versus Cetuximab, yielding a dominant ICER (-120, 743/QALY). Sensitivity and scenario analyses confirmed robustness. Conclusion Cetuximab-β plus FOLFIRI represents a dominant, cost-saving strategy compared to Cetuximab plus chemotherapy for first-line treatment of RAS/BRAF wild-type mCRC in China.
Tong et al. (Mon,) studied this question.