Supplementary data: Adverse event costs of systemic therapies for metastatic colorectal cancer previously treated with fluoropyrimidine-, oxaliplatin and irinotecan-based chemotherapy and biologics in the US

These are peer-reviewed supplementary materials for the article 'Adverse event costs of systemic therapies for metastatic colorectal cancer previously treated with fluoropyrimidine-, oxaliplatin and irinotecan-based chemotherapy and biologics in the US' published in the Journal of Comparative Effectiveness Research.Supplementary Table 1: Summary of clinical trial study characteristics.Supplementary Table 2: Summary of patient baseline characteristics from clinical trials.Supplementary Table 3: Detailed unit cost information for the Commercial perspective.Supplementary Table 4: Detailed unit cost information for the Medicare perspective.Aim: The objective of this study was to compare adverse event (AE) management costs for fruquintinib, regorafenib, trifluridine/tipiracil (T/T) and trifluridine/tipiracil+bevacizumab (T/T+bev) for patients with metastatic colorectal cancer (mCRC) previously treated with at least two prior lines of therapy from the US commercial and Medicare payer perspectives. Materials & methods: A cost-consequence model was developed to calculate the per-patient and per-patient-per-month (PPPM) AE costs using rates of grade 3/4 AEs with incidence ≥5% in clinical trials, event-specific management costs and duration treatment. Anchored comparisons of AE costs were calculated using a difference-in-differences approach with best supportive care (BSC) as a common reference. AE rates and treatment duration were obtained from clinical trials: FRESCO and FRESCO-2 (fruquintinib), RECOURSE (T/T), CORRECT (regorafenib) and SUNLIGHT (T/T, T/T+bev). AE management costs for the commercial and Medicare perspectives were obtained from publicly available sources. Results: From the commercial perspective, the AE costs (presented as perpatient, PPPM) were: $4015, $1091 for fruquintinib (FRESCO); $4253, $1390 for fruquintinib (FRESCO-2); $17,110, $11,104 for T/T (RECOURSE); $9851, $4691 for T/T (SUNLIGHT); $8199, $4823 for regorafenib; and $11,620, $2324 for T/T+bev. These results were consistent in anchored comparisons: the difference in-difference for fruquintinib based on FRESCO was -$1929 versus regorafenib and -$11,427 versus T/T; for fruquintinib based on FRESCO-2 was -$2257 versus regorafenib and -$11,756 versus T/T. Across all analyses, results were consistent from theMedicare perspective. Conclusion: Fruquintinib was associated with lower AE management costs compared with regorafenib, T/T and T/T+bev for patients with previously treated mCRC. This evidence has direct implications for treatment, formulary and pathways decision-making in this patient population.

本数据集为发表于《比较疗效研究杂志》的论文《美国既往接受氟嘧啶类、奥沙利铂和伊立替康为基础的化疗和生物制剂治疗的转移性结直肠癌系统性治疗不良反应成本》的同行评审补充材料。补充表1：临床试验研究特征的概述。补充表2：临床试验患者基线特征的概述。补充表3：从商业视角详细列出单位成本信息。补充表4：从医疗保险视角详细列出单位成本信息。研究目标：本研究的目的是从美国商业和医疗保险支付者的视角，比较氟喹诺酮、雷戈拉非尼、三氟尿苷/替加氟（T/T）和三氟尿苷/替加氟+贝伐珠单抗（T/T+bev）在既往至少接受过两线治疗的患者中转移性结直肠癌（mCRC）的不良反应（AE）管理成本。研究方法：建立了一种成本后果模型，以计算每位患者和每位患者每月（PPPM）的AE成本，使用临床试验中≥5%发病率的3/4级AE发生率、事件特定的管理成本和治疗持续时间。使用最佳支持治疗（BSC）作为共同参照，通过双重差分法计算了锚定AE成本比较。AE发生率和治疗持续时间来自临床试验：FRESCO和FRESCO-2（氟喹诺酮）、RECOURSE（T/T）、CORRECT（雷戈拉非尼）和SUNLIGHT（T/T，T/T+bev）。商业和医疗保险视角下的AE管理成本来自公开可获取的来源。结果：从商业视角来看，AE成本（以每位患者、PPPM表示）如下：氟喹诺酮（FRESCO）为4015美元、1091美元；氟喹诺酮（FRESCO-2）为4253美元、1390美元；T/T（RECOURSE）为17110美元、11104美元；T/T（SUNLIGHT）为9851美元、4691美元；雷戈拉非尼为8199美元、4823美元；T/T+bev为11620美元、2324美元。这些结果在锚定比较中一致：基于FRESCO的氟喹诺酮与雷戈拉非尼的差异为-1929美元，与T/T的差异为-11427美元；基于FRESCO-2的氟喹诺酮与雷戈拉非尼的差异为-2257美元，与T/T的差异为-11756美元。在所有分析中，医疗保险视角的结果一致。结论：与雷戈拉非尼、T/T和T/T+bev相比，氟喹诺酮与既往接受过治疗的mCRC患者的不良反应管理成本较低。该证据对该患者群体的治疗、药品目录和路径决策具有直接的启示意义。