The analysis was conducted to assess the pharmacological costs of regorafenib and trifluridine/tipiracil in the treatment of refractory metastatic colorectal cancer (mCRC). Pivotal phase III randomized controlled trials (RCTs) of regorafenib and trifluridine/tipiracil in the treatment of refractory mCRC were considered. We have also considered the ReDOS trial, in order to verify if the dose-escalation strategy (practice changing for regorafenib) could influences the results. Differences in OS (expressed in months) between the different arms were calculated and compared with the pharmacological costs (at the Pharmacy of our Hospital and expressed in euros (euro)) needed to get one month of OS. Trifluridine/tipiracil resulted the less expensive, with 1167.50 europer month OS-gained. The ReDOS trial further reduce costs with 510.41 europer month OS-gained in favour of regorafenib with the escalation-dose strategy. Both regorafenib and trifluridine/tipiracil can be considered economically sustainable treatments for refractory mCRC, apparently with a lower cost of trifluridine/tipiracil. The adoption of a dose-escalation strategy (ReDOS trial) could reverse the situation making regorafenib more cost-effective than trifluridine/tipiracil.

Dose-escalation strategy in refractory metastatic colorectal cancer: A change in terms of cost-effectiveness

Ruzzenente, Andrea;
2021

Abstract

The analysis was conducted to assess the pharmacological costs of regorafenib and trifluridine/tipiracil in the treatment of refractory metastatic colorectal cancer (mCRC). Pivotal phase III randomized controlled trials (RCTs) of regorafenib and trifluridine/tipiracil in the treatment of refractory mCRC were considered. We have also considered the ReDOS trial, in order to verify if the dose-escalation strategy (practice changing for regorafenib) could influences the results. Differences in OS (expressed in months) between the different arms were calculated and compared with the pharmacological costs (at the Pharmacy of our Hospital and expressed in euros (euro)) needed to get one month of OS. Trifluridine/tipiracil resulted the less expensive, with 1167.50 europer month OS-gained. The ReDOS trial further reduce costs with 510.41 europer month OS-gained in favour of regorafenib with the escalation-dose strategy. Both regorafenib and trifluridine/tipiracil can be considered economically sustainable treatments for refractory mCRC, apparently with a lower cost of trifluridine/tipiracil. The adoption of a dose-escalation strategy (ReDOS trial) could reverse the situation making regorafenib more cost-effective than trifluridine/tipiracil.
Refractory metastatic colorectal cancer
cost of drugs
regorafenib
trifluridine/tipiracil
Antineoplastic Combined Chemotherapy Protocols
Colorectal Neoplasms
Cost-Benefit Analysis
Dose-Response Relationship, Drug
Drug Combinations
Drug Costs
Humans
Phenylurea Compounds
Pyridines
Pyrrolidines
Thymine
Trifluridine
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1078693
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