Related Experiment Video
Updated: Apr 5, 2026
Detection of a Circulating MicroRNA Custom Panel in Patients with Metastatic Colorectal Cancer
Published on: March 14, 2019
Cost-Effectiveness Analysis of Regorafenib for Metastatic Colorectal Cancer
Daniel A Goldstein1, Bilal B Ahmad2, Qiushi Chen2
1Daniel A. Goldstein, Bilal B. Ahmad, David H. Howard, Joseph Lipscomb, Bassel F. El-Rayes, and Christopher R. Flowers, Emory University; and Qiushi Chen and Turgay Ayer, Georgia Institute of Technology, Atlanta, GA. dgolds8@emory.edu.
Purpose:
Regorafenib is a standard-care option for treatment-refractory metastatic colorectal cancer that increases 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 cost-effectiveness 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.
