ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1568385
Network Meta-Analysis and Cost-Effectiveness Analysis Comparing Cetuximabβ and Cetuximab for Chinese Patients With RAS/BRAF Wild-Type Metastatic Colorectal Cancer
Provisionally accepted
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
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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. Conclusions: 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.
Keywords: Cetuximab-β, cetuximab, Metastatic colorectal cancer, Network meta-analysis, cost-effectiveness analysis
Received: 29 Jan 2025; Accepted: 20 Aug 2025.
Copyright: © 2025 Tong, Yang, Zhang, Zhou, Wang, Lu and Chang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yun Lu, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
Feng Chang, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
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