PCN36 DEVELOPING HEALTH STATE DESCRIPTIONS FOR METASTATIC COLORECTAL CANCER: QUALITATIVE STUDY

133 Background: Adding cetuximab to FOLFIRI chemotherapy (cet+CT) as first-line (1L) treatment for RAS wild-type (wt) metastatic colorectal cancer (mCRC) has been reported as cost-effective vs bevacizumab + FOLFIRI (bev+CT) in multiple jurisdictions. This study determined the cost-effectiveness (CE) of cet+CT for patients with mCRC in China. Methods: A published 3–health-state (nonprogressive, progressive, death) CE model was adapted to reflect Chinese patient characteristics, health state utilities, unit costs, and discounting rates, applying FIRE-3 trial–based resource utilization and adverse event rates. Progression-free and overall survival estimates were based on published FIRE-3 trial simulations to statistically adjust for available later-line treatment modalities in China vs those observed in FIRE-3. [1] Cetuximab and bevacizumab costs were based on up-to-date prices after the 2019 national reimbursement drug listing negotiations. Incremental CE ratios (ICERs) are given as cost (Chinese Yuan [¥]) per life-year (LY) and quality-adjusted LY (QALY) gained. The willingness-to-pay (WTP) threshold was ¥193,931, equivalent to 3 times the gross domestic product per capita, following WHO guidance. Results: Overall costs/costs restricted to 1L treatment were ¥483,771/¥249,619 (cet+CT) and ¥366,036/¥156,802 (bev+CT). Health effects were 3.32/2.68 (cet+CT) and 2.39/1.94 (bev+CT) LYs/QALYs gained. Discounted ICERs for cet+CT vs bev+CT were ¥148,311 and ¥186,517 per LY and QALY gained in deterministic analysis. cet+CT had a 71.8% (LY) and 52.5% (QALY) probability of being cost-effective. Treatment duration with a biologic in 1L, utilities in 3L treatment, and duration of 2L treatment were the main outcome drivers. Conclusions: Projections suggest that cet+CT is cost-effective vs bev+CT for 1L treatment of patients with RAS wt mCRC in China, with ICERs below the current WTP threshold in deterministic and probabilistic sensitivity analyses. [1] Van Oostrum I, et al. Value Health. 2020;23(Suppl 1): S8.

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Assessing health-state utility values in patients with metastatic colorectal cancer: a utility study in the United Kingdom and the Netherlands

International Journal of Colorectal Disease ◽

10.1007/s00384-014-1980-1 ◽

2014 ◽

Vol 29 (10) ◽

pp. 1203-1210 ◽

Cited By ~ 14

Author(s):

Dara Stein ◽

F. Joulain ◽

S. Naoshy ◽

U. Iqbal ◽

N. Muszbek ◽

...

Keyword(s):

Colorectal Cancer ◽

United Kingdom ◽

The Netherlands ◽

Metastatic Colorectal Cancer ◽

Health State Utility ◽

Health State ◽

Utility Values ◽

The United Kingdom ◽

Health State Utility Values

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Patients’ experiences of ongoing palliative chemotherapy for metastatic colorectal cancer: a qualitative study

International Journal of Palliative Nursing ◽

10.12968/ijpn.2014.20.5.218 ◽

2014 ◽

Vol 20 (5) ◽

pp. 218-224 ◽

Cited By ~ 7

Author(s):

Jenny Cameron ◽

Susan Waterworth

Keyword(s):

Colorectal Cancer ◽

Qualitative Study ◽

Metastatic Colorectal Cancer ◽

Palliative Chemotherapy

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TP6.1.5 The Importance of the Patient Voice in Metastatic Colorectal Cancer: A Qualitative Study

British Journal of Surgery ◽

10.1093/bjs/znab362.026 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Anthony Chan ◽

Agnieszka Ignatowicz ◽

James Mason ◽

Ajith Siriwardena

Keyword(s):

Colorectal Cancer ◽

Qualitative Study ◽

Metastatic Colorectal Cancer ◽

Phenomenological Study ◽

Qualitative Interviews ◽

Large Body ◽

The Body ◽

Important Message ◽

Synchronous Resection ◽

The Uk

Abstract Aims Colorectal cancer is the fourth commonest cancer in the UK with a third presenting with synchronous liver metastases. Although there is a large body of clinical cohort data, there is no research exploring patient perspectives of disease. This qualitative phenomenological study explores the lived experiences of patients following treatment for synchronous disease. Methods Qualitative interviews used pre-prepared prompts encouraging open dialogue and were transcribed for thematic analysis. Results Four major themes emerged. (1) Experience of Cancer The initial diagnosis was recalled in vivid detail, with delays perceived negatively particularly if clinicians were dismissive about their concerns. Caregiver participation was valued in consultations. Patients with recurrence perceived chemotherapy as a method of control. (2) Patient Autonomy Patients describe a paternalistic relationship with their clinician and were satisfied with their management despite any complications or recurrence. There was little perception of pathway equipoise with some questioning any real choice particularly those with a symptomatic bowel primary. (3) Treatment Strategy Patients preferred a bowel-first strategy as a method of control, perceiving the primary to continually seed the body with metastases. Chemotherapy offered little reassurance for disease control. Synchronous resection was preferred but the greater potential for complications was appreciated. (4) Research No patients expressed ethical concerns about potential studies randomising to different surgical strategies. However, patients would not want a liver-first strategy. Conclusions This is the first qualitative study exploring patient perceptions of metastatic colorectal cancer. The importance of the first consultation outlining management is emphasised as a simple but important message.

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Psychological distance: a qualitative study of screening barriers among first-degree relatives of colorectal cancer patients

BMC Public Health ◽

10.1186/s12889-021-10786-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xueying Zhang ◽

Yiheng Zhang ◽

Jingyu Chen ◽

Meifen Zhang ◽

Ni Gong

Keyword(s):

Colorectal Cancer ◽

High Risk ◽

Qualitative Study ◽

Qualitative Content Analysis ◽

Psychological Distance ◽

Spatial Distance ◽

Health Examination ◽

Health State ◽

First Degree Relatives ◽

Incidence And Mortality

Abstract Background Colorectal cancer screening can reduce the incidence and mortality through early detection. First-degree relatives (FDRs) of patients with colorectal cancer are at high risk for colorectal cancer and therefore require colonoscopy. However, despite the high risk, screening adherence among FDRs remains low and the barriers to undergoing screening among FDRs in China are not clear. We explored the reasons why FDRs refused screening. Methods In this qualitative study, 28 semistructured, in-depth interviews were conducted face-to-face. Participants were recruited at two hospitals (an urban tertiary hospital and a community health center) in Guangzhou, South China. We used qualitative content analysis to analyze transcripts based on audio recordings and identify major themes and subthemes. Results Three major themes emerged related to FDRs’ low screening participation. First, the emotional distance between FDRs and medicine was pulled away by uncomfortable feelings approaching hospitals and misunderstanding of cancer. Second, they confirmed their health state and minimized cancer risk if they had no signs in routine health examination, no symptoms and maintained a healthy, happy life. Third, they considered screening far from their daily life from the perspective of spatial distance and priority. Therefore, screening was not necessary in their view. Conclusions Healthcare professionals should narrow psychological distance between people and screening when promoting screening technology.

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