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. 2024 Nov 13:12:1465898.
doi: 10.3389/fpubh.2024.1465898. eCollection 2024.

Cost-effectiveness analysis of trifluridine/tipiracil combined with bevacizumab vs. monotherapy for third-line treatment of colorectal cancer

Long-Zhuan Huang  1 , Ya-Qing Chen  1 , Hang-Ye Gu  1 , Yong Chen  1
Affiliations

Cost-effectiveness analysis of trifluridine/tipiracil combined with bevacizumab vs. monotherapy for third-line treatment of colorectal cancer

Long-Zhuan Huang et al. Front Public Health. .

Abstract

Background: The combination of trifluridine/tipiracil (FTD/TPI) and bevacizumab has demonstrated promising efficacy and safety in the treatment of colorectal cancer (CRC). This study aims to evaluate the cost-effectiveness of trifluridine/tipiracil combined with bevacizumab vs. trifluridine/tipiracil monotherapy as a third-line treatment regimen for colorectal cancer within the Chinese healthcare system, providing an economic basis for clinical application.

Methods: Based on data from the SUNLIGHT Phase III clinical trial, a dynamic Markov model was constructed with a cycle length of 4 weeks and a simulation duration of 10 years. Direct medical costs and quality-adjusted life years (QALYs) were calculated. The incremental cost-effectiveness ratio (ICER) was compared with the willingness-to-pay threshold (WTP = ¥268,200.00/QALY) to assess the economic viability of the treatment regimen. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to verify the robustness of the model results.

Results: The cost of trifluridine/tipiracil combined with bevacizumab treatment (¥838,492.74) was higher than that of trifluridine/tipiracil monotherapy (¥357,396.97), with greater health benefits (2.45 QALYs vs. 1.54 QALYs). The ICER was ¥527,577.36/QALY, exceeding the willingness-to-pay threshold. One-way sensitivity analysis indicated that drug costs and utility values during the progression-free period significantly impacted model outputs. Probabilistic sensitivity analysis further confirmed the robustness of the results, showing that at a willingness-to-pay threshold of ¥494,000.00, the probability of the combined treatment being cost-effective was 50%.

Conclusion: Trifluridine/tipiracil combined with bevacizumab, as a third-line treatment for colorectal cancer, does not have a cost-effectiveness advantage compared to trifluridine/tipiracil monotherapy in economic evaluations.

Keywords: Markov model; bevacizumab; colorectal cancer; cost-effectiveness analysis; trifluridine/tipiracil.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Markov model transition diagram for each state.
Figure 2
Figure 2
Overall survival reconstruction curve.
Figure 3
Figure 3
Progression-free survival reconstruction curve.
Figure 4
Figure 4
Parameters of OS curve fitting for FTP-TPI plus bevacizumab.
Figure 5
Figure 5
Parameter plot of PFS curve fitting for FTP-TPI plus bevacizumab.
Figure 6
Figure 6
Tornado diagram for one-factor sensitivity analysis.
Figure 7
Figure 7
Incremental Cost-Effectiveness Scatterplot.
Figure 8
Figure 8
Cost-Effectiveness Acceptability Curve.
See this image and copyright information in PMC

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