Cost-Effectiveness of Fruquintinib for Refractory Metastatic Colorectal Cancer in the USA

Dong-Won Kang, Patricio B. Lynn, Li Wang, Shouhao Zhou and Chan Shen ()
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Dong-Won Kang: The Pennsylvania State University
Patricio B. Lynn: The Pennsylvania State University
Li Wang: Penn State College of Medicine
Shouhao Zhou: Penn State College of Medicine
Chan Shen: The Pennsylvania State University

PharmacoEconomics - Open, 2025, vol. 9, issue 1, No 9, 93-101

Abstract: Abstract Background The FRESCO-2 trial established the efficacy and safety of fruquintinib in patients with refractory metastatic colorectal cancer. However, its cost-effectiveness in the US context is not well documented. Objective This study evaluates the cost-effectiveness of fruquintinib versus placebo for this patient population from the perspective of US payers. Methods We developed a partitioned survival model on the basis of patient-level data reconstructed from the survival curves of the FRESCO-2 trial. Parametric estimation was conducted to estimate long-term clinical outcomes and medical costs over a lifetime horizon. Cost inputs and utilities were sourced from public data and previous literature. We used a discount rate of 3.0% per year for both clinical outcomes and costs. We adopted an incremental cost-effectiveness ratio (ICER) threshold of US$100,000 per quality-adjusted life-year (QALY) gained. We performed sensitivity and scenario analyses to examine the robustness of cost-effectiveness results. Results Fruquintinib treatment resulted in incremental gains of 0.108 life years (LYs) and 0.073 QALYs compared with the placebo, at an additional cost of US$112,294, primarily driven by medication expenses. The ICER for fruquintinib versus placebo was calculated at US$1,037,855 per LY and US$1,546,619 per QALY gained, exceeding the predefined cost-effectiveness threshold. The cost-effectiveness results were robust across all sensitivity and scenario analyses. Conclusion and Relevance Despite the survival benefit, fruquintinib was not cost-effective compared with the placebo in patients with refractory metastatic colorectal cancer in the US setting, on the basis of the conventional willingness-to-pay threshold. Our findings may provide a basis for informing the pricing and reimbursement decisions regarding fruquintinib.

Date: 2025
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DOI: 10.1007/s41669-024-00529-z

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