Five-year survival and costs of care in metastatic colorectal cancer: conventional versus monoclonal antibody-based treatment protocols

Research output: Contribution to journalArticle


AIM: To evaluate the costs and survival estimates of metastatic colorectal carcinoma patients treated with conventional cytostatic protocols and adjuvant monoclonal antibodies (mAbs).

METHODS: Retrospective randomized case series and cost-of-illness analysis was used. Metastatic colorectal carcinoma cases (62) were randomly selected from the archive of the largest university military hospital in Southeastern Europe.

RESULTS: A 6-month longer survival was attributed to mAbs (p = 0.581). Conventional protocols incurred € 5137 (95% CI: € 3758-€ 6517) versus € 22,113 (95% CI: € 16,201-€ 28,025) total direct medical costs in mAb-based group. ICER of € 32,108 per life year gained attributable to mAbs three-fold exceeded informal willingness to pay threshold of Serbia.

CONCLUSION: mAbs adjuvant protocols had modest positive impact on 5-year survival rates. Costs were driven by targeted biologicals, but significantly higher costs of care were recorded in mAb-treated group in other domains, as well. More selective prescription and reimbursement criteria should be applied to increase cost-effectiveness of targeted oncology agents.


  • Aleksandra Kovacevic
  • Viktorija Dragojevic-Simic
  • Dino Tarabar
  • Nemanja Rancic
  • Nemanja Jacimovic
  • Jelena Katic
  • Aleksandar Dagovic
  • Mihajlo Jakovljevic
External organisations
  • University of Kragujevac
Research areas and keywords


  • Aged, Antibodies, Monoclonal/economics, Antineoplastic Combined Chemotherapy Protocols/economics, Colorectal Neoplasms/drug therapy, Cost-Benefit Analysis, Female, Hospitals, Military, Hospitals, University, Humans, Male, Middle Aged, Neoplasm Metastasis, Randomized Controlled Trials as Topic, Retrospective Studies, Serbia, Survival Rate
Original languageEnglish
Pages (from-to)963-70
JournalExpert Review of Anticancer Therapy
Issue number8
Publication statusPublished - 2015
Publication categoryResearch
Externally publishedYes