Abstract
To evaluate, from a US payer perspective, the cost-effectiveness of treatment strategies for metastatic colorectal cancer (mCRC), we performed a systematic review of published cost-effectiveness analyses. We identified 14 papers that fulfilled our search criteria and revealed varying levels of value among current treatment strategies. Older agents such as 5-fluorouracil, irinotecan, and oxaliplatin provide high-value treatments. More modern agents targeting the EGFR or VEGF pathways, such as bevacizumab, cetuximab, and panitumumab, do not appear to be cost-effective treatments at their current costs. The analytical methods used within the papers varied widely, and this variation likely plays a significant role in the heterogeneity in incremental cost-effectiveness ratios. The cost-effectiveness of current treatment strategies for mCRC is highly variable. Drugs recently approved by the US Food and Drug Administration for mCRC are not cost-effective, and this is primarily driven by high drug costs.
Keywords:
Chemotherapy; Colorectal cancer; Cost-effectiveness; Incremental cost effectiveness ratio; Value.
Copyright © 2016 Elsevier Inc. All rights reserved.
MeSH terms
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Angiogenesis Inhibitors / economics
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Angiogenesis Inhibitors / therapeutic use*
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Antibodies, Monoclonal / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / economics
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Bevacizumab / administration & dosage
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Bevacizumab / economics
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Camptothecin / administration & dosage
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Camptothecin / analogs & derivatives
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Camptothecin / economics
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Camptothecin / therapeutic use
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Cetuximab / administration & dosage
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Cetuximab / economics
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Colorectal Neoplasms / drug therapy*
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Colorectal Neoplasms / pathology
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Cost-Benefit Analysis
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Drug Costs
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Fluorouracil / administration & dosage
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Fluorouracil / economics
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Fluorouracil / therapeutic use
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Humans
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Irinotecan
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Leucovorin / economics
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Leucovorin / therapeutic use
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Neoplasm Metastasis / drug therapy*
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Organoplatinum Compounds / administration & dosage
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Organoplatinum Compounds / economics
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Oxaliplatin
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Panitumumab
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Quality-Adjusted Life Years*
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Treatment Outcome
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United States
Substances
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Angiogenesis Inhibitors
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Antibodies, Monoclonal
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Organoplatinum Compounds
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Oxaliplatin
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Bevacizumab
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Panitumumab
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Irinotecan
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Cetuximab
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Leucovorin
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Fluorouracil
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Camptothecin