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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.
Keywords
Metastatic colorectal cancer, Cost-effectiveness analysis, Fruquintinib
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View the published article at BMC Cancer.
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Posted 10 Oct, 2020
No community comments so far
Submission checks complete
On 01 Oct, 2020
Editorial decision: Accept
On 01 Oct, 2020
No comments provided
Reviewer #2 agreed
On 14 Jul, 2020
Reviewer #1 agreed
On 12 Jul, 2020
Review #1 received
Received 12 Jul, 2020
Reviewers invited
Invitations sent on 11 Jul, 2020
Editor assigned
On 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 01 Jul, 2020
Review #2 received
Received 17 Jun, 2020
Reviewer #2 agreed
On 15 Jun, 2020
Review #1 received
Received 19 Apr, 2020
Reviewer #1 agreed
On 17 Apr, 2020
Reviewers invited
Invitations sent on 20 Mar, 2020
Editor assigned
On 26 Feb, 2020
First submitted
On 25 Feb, 2020
Submission checks complete
On 25 Feb, 2020
Editor invited
On 25 Feb, 2020
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See the published version of this preprint at BMC Cancer.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Cancer.
Version 3
Posted 10 Oct, 2020
No community comments so far
Submission checks complete
On 01 Oct, 2020
Editorial decision: Accept
On 01 Oct, 2020
No comments provided
Reviewer #2 agreed
On 14 Jul, 2020
Reviewer #1 agreed
On 12 Jul, 2020
Review #1 received
Received 12 Jul, 2020
Reviewers invited
Invitations sent on 11 Jul, 2020
Editor assigned
On 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 01 Jul, 2020
Review #2 received
Received 17 Jun, 2020
Reviewer #2 agreed
On 15 Jun, 2020
Review #1 received
Received 19 Apr, 2020
Reviewer #1 agreed
On 17 Apr, 2020
Reviewers invited
Invitations sent on 20 Mar, 2020
Editor assigned
On 26 Feb, 2020
First submitted
On 25 Feb, 2020
Submission checks complete
On 25 Feb, 2020
Editor invited
On 25 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cancer.
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.
Figure 1
Figure 2
Figure 3
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