Metastatic Colorectal Cancer: A Systematic Review of the Value of Current Therapies
Daniel A. Goldstein,1 Simon B. Zeichner,1 Catherine M. Bartnik,2 Eli Neustadter,1
Christopher R. Flowers1
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 costeffectiveness 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.
Clinical Colorectal Cancer, Vol. -, No. -, --- ª 2015 Elsevier Inc. All rights reserved.
Keywords: Chemotherapy, Colorectal cancer, Cost-effectiveness, Incremental cost effectiveness ratio, Value
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