Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Dr. Sisira Sarma

2nd Supervisor

Dr. Greg Zaric

Joint Supervisor


I conducted a cost-effectiveness analysis of combination cetuximbab or panitumumab plus FOLFIRI as first-line treatment for patients with metastatic colorectal cancer (MCRC) from the perspective of the Ontario healthcare payer. I developed a Markov decision analytical model to simulate the lifetime costs and benefits of each treatment option. The model was parameterized using data collected from administrative databases in the province of Ontario and from published clinical trials. In the base case scenario, treatment consisting of bevacizumab plus FOLFIRI was found to dominate other treatment options. The ICER values were found to be sensitive to the efficacy of first-line treatment, cost of bevacizumab and cetuximab, and health utility values. In conclusion bevacizumab plus FOLFIRI for first-line treatment of patients with metastatic colorectal cancer, the current standard of care in Ontario is the most cost-effective treatment option for these patients.