Cost Versus Benefit Among Chemotherapy Drugs for Metastatic Colorectal Cancer
New chemotherapy agents for metastatic colorectal cancer modestly improve survival time but come with substantial costs, according to the results of a study published in the Archives of Internal Medicine.
Metastatic colorectal cancer refers to cancer that has spread from the colon to distant sites in the body. Though metastatic colorectal cancer is considered incurable, many new chemotherapy agents have been shown to prolong survival time. However, these agents are costly and have been described as “high-cost/low-value” medical care.
Researchers from Emory University used the Surveillance, Epidemiology, and End Results-Medicare database to evaluate data from 4,665 patients (age 66 and older) diagnosed with metastatic colorectal cancer between 1995 and 2005. All patients received chemotherapy during treatment. The researchers estimated life expectancy and medical costs based on short-term survival rates and costs.
They found that life expectancy increased by 6.8 months, and lifetime costs increased by $37,100; this translated into a cost per life-year gained of $66,200. After adjusting for out-of-pocket costs and other factors, the cost per quality-adjusted life-year gained was $99,100. Although this cost does fall below the commonly cited estimates of the “willingness-to-pay for a life-year,” it still represents a great cost, and the researchers speculate that these costs will continue to rise.
 Howard DH, Kauh J, Lipscomb J. The value of new chemotherapeutic agents for metastatic colorectal cancer. Archives of Internal Medicine. 2010; 170: 537-542.