Cost-effectiveness of Trifluridine/tipiracil for Previously Treated Metastatic Colorectal Cancer in England and Wales

Bullement, Ash; Underhill, Stuart; Fougeray, Ronan; Hatswell, Anthony J.

doi:10.1016/j.clcc.2017.09.001

Cited by 28 publications

(24 citation statements)

References 10 publications

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“…The ICER for TAS-102 was £51, 194 per QALY. After the probabilistic analysis, TAS-102 showed an > 60% probability to achieve a 3-months OS gain [27]. Similar to regorafenib, fruquintinib failed to show cost-effectiveness in our study.…”

Section: Discussionmentioning

confidence: 49%

Cost-effectiveness analysis of fruquintinib for metastatic colorectal cancer third-line treatment in China

et al. 2020

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Background In this study, we analyze the cost-effectiveness of fruquintinib as third-line treatment for patients with metastatic colorectal cancer in China, especially after a recent price drop suggested by the National Healthcare Security Administration. Methods A Markov model was developed to investigate the cost-effectiveness of fruquintinib compared to placebo among patients with metastatic colorectal cancer. Effectiveness was measured in quality-adjusted life years (QALY). The Chinese healthcare payer’s perspective was considered with a lifetime horizon, including direct medical cost (2019 US dollars [USD]). A willing-to-pay threshold was set at USD 27,130/QALY, which is three times the gross domestic product (GDP) per capita. We examined the robustness of the model in one-way and probabilistic sensitivity analysis. Results Fruquintinib was associated with better health outcomes than placebo (0.640 vs 0.478 QALYs) with a higher cost (USD 20750.9 vs USD 12042.2), resulting in an incremental cost-effectiveness ratio (ICER) of USD 53508.7 per QALY. This ICER is 25% lower than the one calculated before the price drop (USD 70952.6 per QALY). Conclusion After the price negotiation, the drug becomes cheaper and the ICER is lower, but the drug is still not cost effective under the standard of 3 times GDP willing-to-pay threshold. For patients with metastatic colorectal cancer in China, fruquintinib is not a cost-effective option under the current circumstances in China.

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Section: Discussionmentioning

confidence: 49%

Cost-effectiveness analysis of fruquintinib for metastatic colorectal cancer third-line treatment in China

et al. 2020

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“…doi:10.1136/esmoopen-2020-000698 and the phase III CORRECT trial for regorafenib. 20 Trifluridine/tipiracil was also shown to be more cost-effective than regorafenib in another study that used data from CORRECT and RECOURSE. 21 However, thus far, only retrospective comparisons of trifluridine/tipiracil and regorafenib in patients with refractory mCRC have been made.…”

Section: Discussionmentioning

confidence: 99%

Safety, efficacy and patient-reported outcomes with trifluridine/tipiracil in pretreated metastatic colorectal cancer: results of the PRECONNECT study

et al. 2020

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BackgroundIn RECOURSE (, trifluridine/tipiracil significantly improved overall survival and progression-free survival (PFS) versus placebo in patients with pretreated metastatic colorectal cancer (mCRC). PRECONNECT was designed to further characterise safety and clinical use of trifluridine/tipiracil.MethodsIn this ongoing, international, multicentre, open-label trial, patients with pretreated mCRC received oral trifluridine/tipiracil 35 mg/m2 twice daily on days 1–5 and 8–12 of each 28-day cycle. The primary endpoint was safety; secondary endpoints included PFS and quality of life (QoL).Results793 patients (median age 62 years) from 13 countries received trifluridine/tipiracil for a median of 2.84 months (IQR 2.64). Adverse events (AEs) were experienced by 96.7%; the most common (≥20% of patients) were neutropaenia, asthenia/fatigue, nausea, anaemia and diarrhoea. Grade ≥3 AEs occurred in 73.9% of patients, with the most common being neutropaenia (39.1% of patients), anaemia (9.8%) and asthenia/fatigue (5.0%). Median PFS was 2.8 months (95% CI 2.7 to 2.9). Median time to Eastern Cooperative Oncology Group performance status deterioration (≥2) was 8.9 months (range 0.03–14.72). There was no clinically relevant change from baseline in QoL.ConclusionsPRECONNECT showed consistent results with the previously demonstrated safety and efficacy profile of trifluridine/tipiracil, with no new safety concerns identified. QoL was maintained during treatment.Trial registration numberNCT03306394.

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“…In western countries, health care budgets are increasingly being used on new oncological treatments targeting cancer patients at their end-of-life, where the effects are marginal, and costs are high both for the society and for patients (in terms of toxicity) [14][15][16] . In countries where the time on waiting list is short and wait list mortality is low, decision makers now have to consider whether LTx is an alternative treatment for patients with non-resectable mCRC.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Versus Open Resection for Colorectal Liver Metastases

et al. 2018

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In patients undergoing parenchyma-sparing liver resection for colorectal metastases, laparoscopic surgery was associated with significantly less postoperative complications compared to open surgery. Laparoscopic resection was cost-effective compared to open resection with a 67% probability. The rate of free resection margins was the same in both groups. Our results support the continued implementation of laparoscopic liver resection.

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Cost-effectiveness of Trifluridine/tipiracil for Previously Treated Metastatic Colorectal Cancer in England and Wales

Cited by 28 publications

References 10 publications

Cost-effectiveness analysis of fruquintinib for metastatic colorectal cancer third-line treatment in China

Cost-effectiveness analysis of fruquintinib for metastatic colorectal cancer third-line treatment in China

Safety, efficacy and patient-reported outcomes with trifluridine/tipiracil in pretreated metastatic colorectal cancer: results of the PRECONNECT study

Laparoscopic Versus Open Resection for Colorectal Liver Metastases

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