Regorafenib for third-line management of metastatic colorectal cancer may provide minimal incremental benefit at high incremental cost per quality-adjust life-years (QALY), according to a recent study published online ahead of print in the Journal of Clinical Oncology.

Researchers led by Daniel Goldstein, MD, of Emory University developed a Markov model in order to compare the cost-effectiveness of regorafenib compared to placebo in these patients.

“Regorafenib is a standard-care option for treatment-refractory metastatic colorectal cancer that increases median overall survival by six weeks compared with placebo,” the authors noted.

Continue Reading

They measured health outcomes in life-years and QALYs, and used Medicare reimbursement rates in 2014 to measure drug costs.

They found that regorafenib provided an additional 0.04 QALYs (0.13 life-years) at a cost of 40,000 dollars, which translated to an incremental cost-effectiveness ratio of 900,000 dollars per QALY.

RELATED: Risk Stratification Could Make Colorectal Cancer Screening More Efficient

Upon univariable and probabilistic sensitivity analyses, incremental cost-effectiveness ratio for regorafenib was found to be greater than 550,000 dollars per QALY.

“The cost-effectiveness of regorafenib could be improved by the use of value-based pricing,” the authors concluded.


  1. Goldstein DA, Ahmad BB, Howard DH, et al. Cost-effectiveness analysis of regorafenib for metastatic colorectal cancer. J Clin Oncol. 2015. [epub ahead of print]. doi: 10.1200/JCO.2015.61.9569.