Cost-effectiveness analysis of regorafenib for metastatic colorectal cancer

Daniel A. Goldstein, Bilal B. Ahmad, Qiushi Chen, Turgay Ayer, David H. Howard, Joseph Lipscomb, Bassel F. El-Rayes, Christopher R. Flowers

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Abstract

Purpose: Regorafenib is a standard-care option for treatment-refractory metastatic colorectal cancer that ncreases median overall survival by 6 weeks compared with placebo. Given this small incremental clinical benefit, we evaluated the cost-effectiveness of regorafenib in the third-line setting for patients with metastatic colorectal cancer from the US payer perspective Methods: We developed a Markov model to compare the cost and effectiveness of regorafenib with those of placebo in the third-line treatment of metastatic colorectal cancer. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Drug costs were based on Medicare reimbursement rates in 2014. Model robustness was addressed in univariable and probabilistic sensitivity analyses Results: Regorafenib provided an additional 0.04 QALYs (0.13 life-years) at a cost of $40,000, resulting in an incremental cost-effectiveness ratio of $900,000 per QALY. The incremental costeffectiveness ratio for regorafenib was > $550,000 per QALY in all of our univariable and probabilistic sensitivity analyses. Conclusion: Regorafenib provides minimal incremental benefit at high incremental cost per QALY in the third-line management of metastatic colorectal cancer. The cost-effectiveness of regorafenib could be improved by the use of value-based pricing

Original languageEnglish (US)
Pages (from-to)3727-3732
Number of pages6
JournalJournal of Clinical Oncology
Volume33
Issue number32
DOIs
StatePublished - Nov 10 2015

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Goldstein, D. A., Ahmad, B. B., Chen, Q., Ayer, T., Howard, D. H., Lipscomb, J., El-Rayes, B. F., & Flowers, C. R. (2015). Cost-effectiveness analysis of regorafenib for metastatic colorectal cancer. Journal of Clinical Oncology, 33(32), 3727-3732. https://doi.org/10.1200/JCO.2015.61.9569