{
  "abstract": "Background: Head and neck cancers (HNC) comprise 5% of all malignancies worldwide. Cetuximab is the first targeted therapy to demonstrate a significant survival benefit in patients with locally advanced HNC (LAHNC) and recurrent or metastatic HNC (R/MHNC). In view of this, we undertook this economic evaluation to ascertain the costs and health benefits associated with (i) the use of RT + CTX over RT alone for LAHNC patients who are ineligible for cisplatin-based chemoradiotherapy and (ii) CT + CTX over CT alone for R/MHNC patients from the perspective of Indian healthcare system.\n\nMethods: A Markov model was constructed to assess the lifetime costs and health outcomes using cetuximab in combination with radiotherapy (RT + CTX) for treatment of cisplatin-ineligible LAHNC ( Analysis I ), and cetuximab in combination with platinum-based chemotherapy (CT + CTX) for treatment of R/MHNC patients in India ( Analysis II ). Using an abridged societal perspective lifetime costs and quality adjusted life years (QALYs) were evaluated, discounting future costs and consequences at 3% annually. For both the analyses, costs of original as well as biosimilar cetuximab were evaluated. The cost-effectiveness was assessed in terms of incremental cost effectiveness ratio (ICER) which was compared against a threshold of 1-time per capita gross domestic product (GDP) for India in 2024–25 (₹ 247,045; US$ 2,697).\n\nResults: Adding biosimilar cetuximab to radiotherapy for cisplatin-ineligible LAHNC patients resulted in 2.73 (95% CI: 2.11–3.30) QALYs, while adding biosimilar cetuximab to platinum-based chemotherapy for R/MHNC resulted in 0.78 (95% CI: 0.61–0.96) QALYs over the modelled lifetime horizon. The incremental cost per QALY gained was found to be ₹ 501,320 with use of RT + CTX and ₹ 15,023,037 with use of CT + CTX. At the currently recommended willingness to pay (WTP) threshold, treatment with cetuximab is not a cost-effective treatment option for patients with LAHNC and R/MHNC patients respectively in India. A 50% reduction in the price of biosimilar would make it a cost-effective option for treatment of LAHNC in India.\n\nConclusion: Strategic purchasing of biosimilar cetuximab at reduced price can provide good value for money for treatment of patients with LAHNC.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Government Medical College and Hospital",
    "Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER)"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nidhi Gupta"
    },
    {
      "affs": [
        1
      ],
      "name": "Jyoti Dixit"
    },
    {
      "affs": [
        1
      ],
      "name": "Gaurav Jyani"
    },
    {
      "affs": [
        1
      ],
      "name": "Shankar Prinja"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2p5fd5qc5grz4.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1948615",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1948615/full",
  "id": "2p5fd5qc5grz4",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1948615/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RM1-950"
    ],
    [
      "openalex",
      "2002|Health Systems, Economic Evaluations, Quality of Life"
    ]
  ],
  "openalex": "W7223294794",
  "pdf_url": "https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1948615/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/2p5fd5qc5grz4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1948615",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1948615/full"
    },
    {
      "first_seen": "2026-10-30T13:43:47Z",
      "native_id": "7371babf9b0b40c08777cfffc6cdc6a9",
      "source": "doaj",
      "url": "https://doi.org/10.3389/fphar.2026.1948615"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RM1-950",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Cost-effectiveness analysis of cetuximab for the treatment of head and neck cancers in India",
  "title_text": "Cost-effectiveness analysis of cetuximab for the treatment of head and neck cancers in India",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:47Z",
  "url": "https://research.draconitic.com/paper/2p5fd5qc5grz4",
  "venue": "Frontiers in Pharmacology",
  "versions": []
}