Cost-effectiveness analysis of larotrectinib vs standard of care for treatment of metastatic NTRK fusion colorectal cancer

BACKGROUND: This study evaluates the cost-effectiveness of larotrectinib compared to the standard of care for treating metastatic NTRK fusion colorectal cancer (CRC) from the perspective of healthcare payers in China. RESEARCH DESIGN AND METHODS: An economic evaluation utilizing a 3-state partitioned survival model assessed the cost-effectiveness of larotrectinib therapy vs regorafenib therapy or larotrectinib therapy vs trifluridine/tipiracil therapy. RESULTS: When the time horizon was 10 years, the anticipated expenditure for larotrectinib therapy exceeded the cost for regorafenib therapy or trifluridine/tipiracil therapy (21,588.50 USD vs 1579.09 USD; 21,588.50 USD vs 2411.16 USD). The estimated utility of larotrectinib therapy was also greater compared to that of regorafenib therapy or trifluridine/tipiracil therapy (1.14 QALYs vs 0.28 QALYs; 1.14 QALYs vs 0.29 QALYs). The ICER of larotrectinib therapy vs regorafenib therapy or larotrectinib therapy vs trifluridine/tipiracil therapy was calculated at 23,321.46 USD/QALY or 22,585.39 USD/QALY. CONCLUSIONS: From the perspective of healthcare payers in China, larotrectinib was cost-effective compared to standard of care as a second-line treatment or subsequent treatment for advanced or metastatic CRC patients with NTRK gene fusion-positive.