{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:38:38Z","timestamp":1792791518236,"version":"4.5.0"},"reference-count":32,"publisher":"Becaris Publishing Limited","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    To estimate the cost\u2013effectiveness of cetuximab in combination with radiotherapy compared with radiotherapy alone, for the treatment of locally advanced head and neck cancer patients in Spain.\n                    <jats:bold>Methods:<\/jats:bold>\n                    A probabilistic Markov model (second-order Monte Carlo simulation) with a five-year time horizon and quarterly Markov cycles was performed from the perspective of the Spanish National Health System (NHS).\n                    <jats:bold>Results:<\/jats:bold>\n                    The additional cost and quality-adjusted life-year (QALY) gain per patient receiving radiotherapy in combination with cetuximab compared with radiotherapy alone was \u20ac4356 (95% CI: \u20ac4350\u20134362) and 0.2380 (95% CI: 0.2370\u20130.2391) QALY, respectively. The incremental cost per QALY gain was \u20ac18,303 (95% CI: \u20ac18,243\u201318,354) with a probability of cost\u2013effectiveness of 65.4% for a willingness to pay of \u20ac30,000 per QALY gained.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    According to the results of this analysis, the addition of cetuximab to radiotherapy would be a cost-effective alternative to radiotherapy alone in the treatment of locally advanced head and neck cancer in Spain.\n                  <\/jats:p>","DOI":"10.57264\/cer-2024-0116","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T09:16:14Z","timestamp":1737969374000},"source":"Crossref","is-referenced-by-count":3,"title":["Cost\u2013effectiveness of cetuximab combined with radiotherapy versus radiotherapy alone in locally advanced head and neck cancer in Spain"],"prefix":"10.57264","volume":"14","author":[{"given":"Ruth \u00c1lvarez","family":"Cabellos","sequence":"first","affiliation":[{"name":"Medical Oncology Department, Virgen de la Salud University Hospital, Avda. 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Cruces, s\/n, 48903, Baracaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana Redondo","family":"Capafons","sequence":"additional","affiliation":[{"name":"Parc Taul\u00ed University Hospital, Pharmacy Department, Parc Taul\u00ed 1, 08208, Sabadell, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi De","family":"los Santos Real","sequence":"additional","affiliation":[{"name":"Merck, SLU, C\/Mar\u00eda de Molina, 40, 28006, Madrid, Spain, an affiliate of Merck KGaA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam Brines","family":"Juli\u00e1n","sequence":"additional","affiliation":[{"name":"Merck, SLU, C\/Mar\u00eda de Molina, 40, 28006, Madrid, Spain, an affiliate of Merck KGaA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dar\u00edo","family":"Rubio-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Health Value, HE Department, C\/Virgen de Ar\u00e1nzazu, 21, 28034, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Rubio-Terr\u00e9s","sequence":"additional","affiliation":[{"name":"Health Value, HE Department, C\/Virgen de Ar\u00e1nzazu, 21, 28034, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","reference":[{"key":"e_1_3_6_3_2","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s12094-020-02533-1","article-title":"SEOM clinical guidelines for the treatment of head and neck cancer (2020","volume":"23","author":"Mesia R","year":"2021","unstructured":"Mesia R, Iglesias L, Lambea J SEOM clinical guidelines for the treatment of head and neck cancer (2020). 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Med."},{"key":"e_1_3_6_6_2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S1470-2045(09)70311-0","article-title":"Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival","volume":"11","author":"Bonner JA","year":"2010","unstructured":"Bonner JA, Harari PM, Giralt J Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol. 11, 21\u201328 (2010).","journal-title":"Lancet Oncol."},{"key":"e_1_3_6_7_2","doi-asserted-by":"crossref","first-page":"788","DOI":"10.4161\/hv.19819","article-title":"The burden of hospitalizations for head and neck neoplasm in Spain (1997\u20132008): an epidemiologic study","volume":"8","author":"Gil-Prieto R","year":"2012","unstructured":"Gil-Prieto R, Viguera-Ester P, \u00c1lvaro-Meca A, San-Mart\u00edn-Rodriguez M, Gil de Miguel \u00c1. The burden of hospitalizations for head and neck neoplasm in Spain (1997\u20132008): an epidemiologic study. Hum. Vaccin. Immunother. 8, 788\u2013798 (2012).","journal-title":"Hum. Vaccin. Immunother."},{"key":"e_1_3_6_8_2","volume-title":"TreeAge Pro Healthcare.","year":"2023","unstructured":"TreeAge Pro Healthcare. 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Consejo general de colegios oficiales de farmac\u00e9uticos. (Accessed: 16 October 2023). https:\/\/botplusweb.farmaceuticos.com\/"},{"key":"e_1_3_6_12_2","volume-title":"Poster Code: EE394. Presented at ISPOR.","author":"Sisam\u00f3n L","year":"2023","unstructured":"Sisam\u00f3n L, Rubi\u00f3 J, Dur\u00e1n O Cost analysis of treatment sequences for recurrent\/metastatic head and neck cancer in the Spanish National Health System. Poster Code: EE394. Presented at ISPOR. Boston, MA, USA (2023) (Accessed: 16 October 2023). https:\/\/www.ispor.org\/docs\/default-source\/intl2023\/isporpescottc2023v2126154-pdf.pdf?sfvrsn=42a3572f_0"},{"key":"e_1_3_6_13_2","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.eimc.2013.06.002","article-title":"An\u00e1lisis de costes y de coste\/eficacia de las pautas preferentes de GESIDA\/Plan Nacional sobre el Sida en 2013 para el tratamiento antirretroviral inicial en adultos infectados por el virus de la inmunodeficiencia humana","volume":"31","author":"Blasco AJ","year":"2013","unstructured":"Blasco AJ, Llibre JM, Arribas JR ; en representaci\u00f3n de GESIDA. An\u00e1lisis de costes y de coste\/eficacia de las pautas preferentes de GESIDA\/Plan Nacional sobre el Sida en 2013 para el tratamiento antirretroviral inicial en adultos infectados por el virus de la inmunodeficiencia humana. Enferm. Infecc. Microbiol. Clin. 31, 568\u2013578 (2013).","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"e_1_3_6_14_2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.2147\/CEOR.S121093","article-title":"Costs of adverse events associated with erlotinib or afatinib in first-line treatment of advanced EGFR-positive non-small cell lung cancer","volume":"9","author":"Isla D","year":"2017","unstructured":"Isla D, De Castro J, Juan O Costs of adverse events associated with erlotinib or afatinib in first-line treatment of advanced EGFR-positive non-small cell lung cancer. ClinicoEcon. Outcomes Res. 9, 31\u201338 (2017).","journal-title":"ClinicoEcon. Outcomes Res."},{"key":"e_1_3_6_15_2","unstructured":"Orden 727\/2017 de 7 de agosto del consejero de Sanidad por la que se fijan los precios p\u00fablicos por la prestaci\u00f3n de los servicios y actividades de naturaleza sanitaria de la red de centros de la Comunidad de Madrid. BOCM no. 198 (2017) (Accessed: 18 October 2023). https:\/\/www.bocm.es\/boletin\/CM_Orden_BOCM\/2017\/08\/21\/BOCM-20170821-1.PDF?fbclid=IwAR3rPHQgalD8Sl35C0z4-nXFzPP1KrOYGSaAZh5tSwEkHasgzyXPRBdV-4w ()."},{"key":"e_1_3_6_16_2","first-page":"87","article-title":"Economic evaluation of desvenlafaxine in the treatment of major depressive disorder in Spain","volume":"9","author":"Rejas Guti\u00e9rrez J","year":"2016","unstructured":"Rejas Guti\u00e9rrez J, Blanca Tamayo M, Gasc\u00f3n Barrachina J, Armada Pel\u00e1ez B. Economic evaluation of desvenlafaxine in the treatment of major depressive disorder in Spain. Rev. Psiquiatr. Salud Ment. 9, 87\u201396 (2016).","journal-title":"Rev. Psiquiatr. Salud Ment."},{"key":"e_1_3_6_17_2","unstructured":"Tarifas para facturaci\u00f3n de servicios sanitarios y docentes del Servicio vasco de salud para el a\u00f1o. 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Oncol."},{"key":"e_1_3_6_20_2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1080\/14737167.2020.1768850","article-title":"Cost of fremanezumab, erenumab, galcanezumab and onabotulinumtoxinA associated adverse events, for migraine prophylaxis in Spain","volume":"21","author":"Irimia P","year":"2021","unstructured":"Irimia P, Santos-Lasaosa S, Garc\u00eda Bujalance L Cost of fremanezumab, erenumab, galcanezumab and onabotulinumtoxinA associated adverse events, for migraine prophylaxis in Spain. Expert Rev. Pharmacoecon. Outcomes Res. 21, 285\u2013297 (2021).","journal-title":"Expert Rev. Pharmacoecon. 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(Accessed: 28 March 2023). https:\/\/www.rtihs.org\/sites\/default\/files\/31413%20Mladsi%202021%20An%20early%20cost-effectiveness%20analysis%20of%20xevinapant%20in%20combination%20with%20chemo-radiotherapy%20in%20patients%20with%20locally%20advanced%20squamous%20cell%20carcinoma%20of%20the%20head%20and%20neck%20in%20United%20States.pdf","journal-title":"Presented at Virtual ISPor"},{"issue":"3","key":"e_1_3_6_23_2","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3310\/hta13suppl3-08","article-title":"Cetuximab for the treatment of recurrent and\/or metastatic squamous cell carcinoma of the head and neck","volume":"13","author":"Greenhalgh J","year":"2009","unstructured":"Greenhalgh J, Bagust A, Boland A Cetuximab for the treatment of recurrent and\/or metastatic squamous cell carcinoma of the head and neck. Health Technol. Assess. 13 (Suppl. 3), 49\u201354 (2009).","journal-title":"Health Technol. Assess."},{"key":"e_1_3_6_24_2","first-page":"2","article-title":"Probabilistic analysis: sensitivity analysis or main result?","volume":"1","author":"Rubio-Terr\u00e9s C","year":"2016","unstructured":"Rubio-Terr\u00e9s C, Rubio-Rodr\u00edguez D. Probabilistic analysis: sensitivity analysis or main result? Pharmacoeconomics 1, 2 (2016).","journal-title":"Pharmacoeconomics"},{"key":"e_1_3_6_25_2","volume-title":"Decision Modelling for Health Economic Evaluation.","author":"Briggs A","year":"2007","unstructured":"Briggs A, Claxton K, Sculpher M. Decision Modelling for Health Economic Evaluation. Oxford University Press, UK (2007)."},{"key":"e_1_3_6_26_2","volume-title":"Applied Methods of Cost\u2013effectiveness Analysis in Healthcare.","author":"Gray AM","year":"2012","unstructured":"Gray AM, Clarke PM, Wolstenholme JL, Wordsworth S. Applied Methods of Cost\u2013effectiveness Analysis in Healthcare. 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