An evaluation of cetuximab dosing strategies using pharmacokinetics and cost analysis
AffiliationCentre for Applied Pharmacokinetic Research, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
MetadataShow full item record
AbstractOBJECTIVES: Cetuximab dosing is based on body surface area (BSA), an approach that is associated with significant wastage due to available vial sizes. NHS England recently introduced an alternative strategy for cetuximab dosing based on dose banding. The aim of this work was to investigate approaches to cetuximab dosing to improve its cost-effectiveness. METHODS: A simulation study using a population pharmacokinetic model was used to assess the performance of dosing strategies using exposure, probability of target attainment and cost. Two dosage regimens (500 and 400/250 mg/m2 ) were investigated; 5% and 10% dose banding, fixed and optimised dosing strategies were evaluated and compared to BSA strategy. KEY FINDINGS: The percentage of the total cost associated with wastage for the 400/250 mg/m2 regimen were 8.75%, 5.13%, 3.61%, 9.2% and 0% for BSA; 5 and 10% bands; fixed and optimal strategies, respectively. Similar results were obtained for 500 mg/m2 regimen. In comparison with BSA strategy, other strategies have comparable or improved performance. Optimised strategy showed consistent performance and ensures equal exposure and probability of target attainment. CONCLUSIONS: Cost-effectiveness of cetuximab treatment can be improved with alternative strategies by reducing wastage without compromising exposure.
CitationOgungbenro K, Patel A, Saunders M, Clark J, Duncombe R. An evaluation of cetuximab dosing strategies using pharmacokinetics and cost analysis. J Pharm Pharmacol. 2019.
JournalThe Journal of pharmacy and pharmacology
- Dose banding as an alternative to body surface area-based dosing of chemotherapeutic agents.
- Authors: Chatelut E, White-Koning ML, Mathijssen RH, Puisset F, Baker SD, Sparreboom A
- Issue date: 2012 Sep 25
- A real-world data approach to determine the optimal dosing strategy for pembrolizumab.
- Authors: Jang A, Nakashima L, Ng T, Fung M, Jiwani S, Schaff K, Suess J, Goncalves R, Jang D, Kuik K, Labelle S, Pow A
- Issue date: 2021 Apr
- Cetuximab Exhibits Sex Differences in Lymphatic Exposure after Intravenous Administration in Rats in the Absence of Differences in Plasma Exposure.
- Authors: Kuilamu E, Subasic C, Cowin GJ, Simpson F, Minchin RF, Kaminskas LM
- Issue date: 2020 Oct 19
- Dose Rationalization of Pembrolizumab and Nivolumab Using Pharmacokinetic Modeling and Simulation and Cost Analysis.
- Authors: Ogungbenro K, Patel A, Duncombe R, Nuttall R, Clark J, Lorigan P
- Issue date: 2018 Apr
- The clinical effectiveness and cost-effectiveness of cetuximab (review of technology appraisal no. 176) and panitumumab (partial review of technology appraisal no. 240) for previously untreated metastatic colorectal cancer: a systematic review and economic evaluation.
- Authors: Huxley N, Crathorne L, Varley-Campbell J, Tikhonova I, Snowsill T, Briscoe S, Peters J, Bond M, Napier M, Hoyle M
- Issue date: 2017 Jun