Cost-Effectiveness Analysis of Metastatic Colorectal Cancer Treatments
Summary
Cost-effectiveness analysis has become a cornerstone in evaluating therapeutic strategies for metastatic colorectal cancer (mCRC), balancing clinical benefits against finite healthcare resources. This approach typically employs decision-analytic models—often Markov or microsimulation frameworks—to compare costs and outcomes across treatment pathways. Outcomes are measured in quality-adjusted life-years (QALYs), which integrate both survival and quality of life, while costs encompass drug acquisition, administration, monitoring and adverse-event management. Incremental cost-effectiveness ratios (ICERs) express additional cost per QALY gained, offering a threshold-based guide for resource allocation. Over the past decade, advances in targeted monoclonal antibodies, companion biomarker testing and immunotherapy have reshaped the mCRC landscape, raising questions about value for money. Economic evaluations now routinely assess the impact of RAS mutation screening on the use of EGFR inhibitors, the value of biomarker-guided prescription and the deployment of checkpoint inhibitors in microsatellite-instability-high populations. These studies inform regulatory decisions, national reimbursement and clinical guidelines, ensuring that emerging therapies offer commensurate benefits in diverse health-system settings worldwide.
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Cost-Effectiveness Analysis of Metastatic Colorectal Cancer Treatments publication trend
The graph below shows the total number of articles in cost-effectiveness analysis of metastatic colorectal cancer treatments across all publications each year (not limited to Nature Index journals).
Technical terms
Incremental cost-effectiveness ratio (ICER): Additional cost per extra quality-adjusted life-year gained when comparing two interventions.
Quality-adjusted life-year (QALY): Composite measure of survival duration and health-related quality of life.
Companion biomarker: Biological marker used to select patients most likely to benefit from a targeted therapy.
Markov model: Analytic framework dividing patient pathways into health states, with transitions over time to estimate costs and outcomes.
RAS wild-type testing: Genetic assay to identify absence of RAS mutations, guiding use of anti-EGFR monoclonal antibodies.
Microsatellite-instability-high (MSI-H): Tumour phenotype characterised by deficient DNA mismatch repair, predictive of response to immune checkpoint inhibitors.
References
- Do cancer biomarkers make targeted therapies cost-effective? A systematic review in metastatic colorectal cancer. PLOS ONE (2018).
- RAS testing and cetuximab treatment for metastatic colorectal cancer: A cost-effectiveness analysis in a setting with limited health resources. Oncotarget (2017).
- Cost-Effectiveness of First-Line Versus Second-Line Pembrolizumab or Chemotherapy in Patients With Microsatellite-Instability-High/Mismatch Repair-Deficient Advanced Colorectal Cancer. Frontiers in Pharmacology (2021).
- How are we evaluating the cost-effectiveness of companion biomarkers for targeted cancer therapies? A systematic review. BMC Cancer (2021).
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