Zhong Jiayun, Liu Yu, Fu Qian, Huang Dan, Gong Wenjun, Zou Jian
Department of Pharmaceutical, the People's Hospital of Pengzhou, Chengdu, Sichuan, 611930, People's Republic of China.
Department of Clinical Pharmacy, the People's Hospital of Pengzhou, Chengdu, Sichuan, 611930, People's Republic of China.
Cancer Manag Res. 2024 Jun 5;16:593-602. doi: 10.2147/CMAR.S464831. eCollection 2024.
Regorafenib, a novel multikinase inhibitor, has been approved by the US Food and Drug Administration as a standard treatment choice for metastatic colorectal cancer (mCRC). Nonetheless, its substantial cost places a significant burden on social health resources and patients. However, the cost-effectiveness (CE) of regorafenib compared to other third-line therapies is still undetermined.
This study aims to assess the CE of regorafenib compared to other third-line therapies for the treatment of mCRC.
We conducted a comprehensive literature search in PubMed, Medline, Scopus, Embase, Cochrane Library, as well as nine other databases to identify relevant studies published up to October 2023, focusing on patients with mCRC and examining the cost-effectiveness of regorafenib. Following the screening and extraction of pertinent data, the study quality was assessed using the Quality of Health Economic Studies (QHES) checklist.
The literature search yielded 751 records, and after applying the inclusion criteria, 13 studies from 7 different countries were included. Of these, 7 studies evaluated the cost-effectiveness of regorafenib compared to trifluridine/tipiracil (TAS-102), 3 studies compared regorafenib with best supportive care (BSC), and 3 studies compared regorafenib with fruquintinib, serplulimab, and regorafenib dose optimization (ReDo).The quality of the included studies was high with an average QHES scores of 85.62. Regorafenib standard dose proves to be less cost-effective than alternative third-line therapies. Implementing a dose optimization strategy could potentially rectify this disparity and enhance the cost-effectiveness of regorafenib.
The use of the standard dose of regorafenib is generally regarded as not cost-effective when compared to other third-line therapies for patients with mCRC. However, implementing a dose-escalation strategy may enhance regorafenib's cost-effectiveness. Consequently, significant price reductions or optimizing the dose of regorafenib are required to achieve cost-effectiveness.
瑞戈非尼是一种新型多激酶抑制剂，已被美国食品药品监督管理局批准为转移性结直肠癌（mCRC）的标准治疗选择。尽管如此，其高昂的成本给社会卫生资源和患者带来了沉重负担。然而，与其他三线疗法相比，瑞戈非尼的成本效益（CE）仍未确定。
本研究旨在评估瑞戈非尼与其他三线疗法治疗mCRC的成本效益。
我们在PubMed、Medline、Scopus、Embase、Cochrane图书馆以及其他九个数据库中进行了全面的文献检索，以识别截至2023年10月发表的相关研究，重点关注mCRC患者并研究瑞戈非尼的成本效益。在筛选和提取相关数据后，使用卫生经济研究质量（QHES）清单评估研究质量。
文献检索产生了751条记录，应用纳入标准后，纳入了来自7个不同国家的13项研究。其中，7项研究评估了瑞戈非尼与曲氟尿苷/替匹嘧啶（TAS-102）相比的成本效益，3项研究将瑞戈非尼与最佳支持治疗（BSC）进行了比较，3项研究将瑞戈非尼与呋喹替尼、斯鲁利单抗和瑞戈非尼剂量优化（ReDo）进行了比较。纳入研究质量较高，平均QHES评分为85.62。事实证明，瑞戈非尼标准剂量的成本效益低于替代三线疗法。实施剂量优化策略可能会纠正这种差异并提高瑞戈非尼的成本效益。
与mCRC患者的其他三线疗法相比，使用瑞戈非尼标准剂量通常被认为不具有成本效益。然而，实施剂量递增策略可能会提高瑞戈非尼的成本效益。因此，需要大幅降价或优化瑞戈非尼剂量以实现成本效益。
