Regorafenib for metastatic colorectal cancer not cost-effective

Last Updated: 2015-08-28

By Will Boggs MD

NEW YORK (Reuters Health) - For patients with metastatic colorectal cancer, regorafenib provides about two extra quality-adjusted weeks of life at a cost of $40,000, according to a cost-effectiveness model.

"Regorafenib is commonly used for patients in the U.S. whose disease has progressed on all other standard chemotherapy options," Dr. Daniel A. Goldstein, from Winship Cancer Institute, Emory University, Atlanta, Georgia, told Reuters Health by email. "It is a standard of care."

In the CORRECT trial, regorafenib treatment was associated with a median overall survival benefit of 1.4 months compared with placebo treatment, and grade 3 to 4 treatment-related adverse events occurred in 54% of patients assigned to regorafenib.

Dr. Goldstein's team used a Markov model to evaluate the cost-effectiveness of regorafenib as a third-line therapy in patients with metastatic colorectal cancer from the perspective of the U.S. payer.

When compared with the best supportive care, regorafenib produced a gain of six weeks of life, which was reduced to two weeks after adjusting for quality of life.

Based on costs of treatment ranging from $32,000 (120 mg dosing) to $43,000 (160 mg dosing), the incremental cost-effectiveness (ICER) ratio ranges from $730,000 to $980,000 per quality-adjusted life-year (QALY), the researchers report in the Journal of Clinical Oncology, online August 24.

In sensitivity analyses, there was nearly 0% probability that regorafenib is cost-effective at willingness to pay (WTP) values below $600,000 per QALY and only a 50% chance that regorafenib is cost-effective even at a WTP of around $900,000 per QALY.

"There is a need for drug prices to correlate to the level of benefit that the drug provides," Dr. Goldstein concluded. "If the benefit is low, the price should be low. If the benefit is high, the price should be high. Value-based pricing would financially incentivize researchers and industry to develop truly game-changing innovations."

SOURCE: http://bit.ly/1UhyFT6

J Clin Oncol 2015.