ArticleCancer2009
Cost implications of new treatments for advanced colorectal cancer.
Article in Cancer, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 6 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Quantitative Evidence Synthesis Methods for the Assessment of the Effectiveness of Treatment Sequences for Clinical and Economic Decision Making: A Review and Taxonomy of Simplifying Assumptions.PharmacoEconomics · 2021Pooled it
- Health Economic Models for Metastatic Colorectal Cancer: A Methodological Review.PharmacoEconomics · 2020Pooled it
- Use of Intermediate Endpoints in the Economic Evaluation of New Treatments for Advanced Cancer and Methods Adopted When Suitable Overall Survival Data are Not Available.PharmacoEconomics · 2016Pooled it
- Metastatic Colorectal Cancer: A Systematic Review of the Value of Current Therapies.Clinical colorectal cancer · 2016Pooled it
- Cost of illness in colorectal cancer: an international review.PharmacoEconomics · 2013Pooled it
- Leveraging learning from a phase III colorectal cancer clinical trial: outcomes, methodology, meta-analysis and pharmacogenetics.Transactions of the American Clinical and Climatological Association · 2010Pooled it
- 3-month versus 6-month adjuvant chemotherapy for patients with high-risk stage II and III colorectal cancer: 3-year follow-up of the SCOT non-inferiority RCT.Health technology assessment (Winchester, England) · 2019Trial
- Cost-effectiveness analysis of selective first-line use of biologics for unresectableCurrent oncology (Toronto, Ont.) · 2019Article
- Do current approaches to assessing therapy related adverse events align with the needs of long-term cancer patients and survivors?Cardio-oncology (London, England) · 2018Review
- Cost-Effectiveness of Treatment Sequences of Chemotherapies and Targeted Biologics for Elderly Metastatic Colorectal Cancer Patients.Journal of managed care & specialty pharmacy · 2017Article
- US-Based Drug Cost Parameter Estimation for Economic Evaluations.Medical decision making : an international journal of the Society for Medical Decision Making · 2015Article
- Oncologists' response to new data regarding the use of epidermal growth factor receptor inhibitors in colorectal cancer.Journal of oncology practice · 2014Observational
- Survival and lifetime costs associated with first-line bevacizumab use in older patients with metastatic colorectal cancer.The oncologist · 2014Article
- Financial Distress in Cancer Patients.Journal of medicine and the person · 2013Article
- Unsupported off-label chemotherapy in metastatic colon cancer.BMC health services research · 2012Article
- Economic burden of cancer in the United States: estimates, projections, and future research.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2011Article
- Treatment of metastatic renal carcinoma patients with the combination of gemcitabine, capecitabine and bevacizumab at a tertiary cancer centre.BJU international · 2011Article
- The evolving role of monoclonal antibodies in colorectal cancer: early presumptions and impact on clinical trial development.The oncologist · 2010Review
- NCCTG Study N9741: leveraging learning from an NCI Cooperative Group phase III trial.The oncologist · 2009Review
- Comparative Effectiveness of Up To Three Lines of Chemotherapy Treatment Plans for Metastatic Colorectal Cancer.MDM policy & practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundSince 1996, 6 new drugs have been introduced for the treatment of metastatic colorectal cancer. Although they are promising, these drugs frequently are given in the palliative and are much more expensive than older treatments. The objective of the current study was to measure the cost implications of treatment with sequential regimens that include chemotherapy and/or monoclonal antibodies.
methodsA Markov model was used to evaluate a hypothetical cohort of 1000 patients with newly diagnosed, metastatic colorectal cancer. Patients supposedly received up to 3 lines of treatment before supportive care and subsequent death. Data were obtained from published, multicenter phase 2 and randomized phase 3 clinical trials. Sensitivity analyses were conducted on the efficacy, toxicity, and cost.
resultsUsing drug costs alone, treatment that included new chemotherapeutic agents increased survival at an incremental cost-effectiveness ratio (ICER) of $100,000 per discounted life-year (DLY). The addition of monoclonal antibodies improved survival at an ICER of >$170,000 per DLY. The results were most sensitive to changes in the initial regimen. Even with significant improvements in clinical characteristics (efficacy and toxicity), treatment with the most effective regimens still had very high ICERs.
conclusionsTreatment of metastatic colorectal cancer with the most effective regimens came at very high incremental costs. The authors concluded that cost-effectiveness analyses should be a routine component of the drug-development process, so that physicians and patients are informed appropriately regarding the value of new innovations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.