Methods for the economic evaluation of personalized medicine: a case study in advanced colorectal cancer
The objectives of the study are:
1) To compare analytical frameworks for valuing heterogeneity in economic evaluation, and consider their relative strengths and weaknesses for potential applications to personalized medicine interventions
2) To evaluate the cost-effectiveness of third-line cetuximab and panitumumab in practice for metastatic colorectal cancer patients with wild-type KRAS compared to best supportive care using observational data and selected analytical frameworks identified in objective 1.
3) To determine the value of further individualization with additional testing of genes in the EGFR pathway to identify patients most likely to respond to cetuximab or panitumumab
For objective 2, I hypothesize cetuximab and panitumumab will be slightly less cost-effective in practice than in initial clinical trial results; however, I expect to see some additional heterogeneity in cost-effectiveness results based on patient and disease characteristics. For objective 3, I anticipate that additional testing will improve the cost-effectiveness of anti-EGFR treatment.