Cost-effectiveness analysis of adagrasib with or without cetuximab in the treatment of colorectal cancer patients with mutated KRAS G12C.

[OBJECTIVES] This study evaluates the cost-effectiveness of adagrasib plus cetuximab in contrast to adagrasib monotherapy in treating colorectal cancer (CRC) patients with mutated KRAS from the perspective of healthcare payers in the USA.

[METHODS] An economic evaluation utilizing a 3-state partitioned survival model assessed the cost-effectiveness of adagrasib plus cetuximab versus adagrasib monotherapy. The Kaplan-Meier curves for overall survival (OS) and progression-free survival (PFS) from a clinical trial were digitally extracted, and the Log-Logistic model was employed at the end of the trial to extrapolate the long-term survivals.

[RESULTS] The estimated cost for adagrasib plus cetuximab treatment was higher than that of adagrasib monotherapy (290,645.434 USD vs 188,837.346 USD). The estimated utility was decreased compared to that of adagrasib monotherapy treatment (1.094 QALYs vs 1.359 QALYs). The ICER was calculated at -384,674.32 USD/QALY, suggesting the adagrasib plus cetuximab therapy did not demonstrate an economic advantage over adagrasib monotherapy for CRC patients with mutated KRAS.

[CONCLUSION] Adagrasib plus cetuximab was not cost-effective compared to adagrasib monotherapy as a late-line treatment for advanced or metastatic CRC patients with mutated KRAS in the USA.