Cost Effectiveness of Fruquintinib for Colorectal Cancer: A systematic review

Background: Colorectal cancer, one of the most prevalent cancers globally, originates from polyps in the colon or rectum, which can develop into cancer over time. It remains a leading cause of cancer-related deaths, imposing significant economic and healthcare burdens. As the incidence of colorectal cancer continues to rise, particularly in developing healthcare systems, understanding the economic impact of treatment options is critical for informing clinical decisions and shaping healthcare policies. Methods: Following PRISMA guidelines, an extensive literature search was conducted through databases including PubMed, Embase, and Scopus up to 7 October 2024. The inclusion criteria targeted studies utilizing cost-effectiveness analysis frameworks like Markov and Partitioned-Survival models, comparing fruquintinib to other cancer treatments. Key outcome measures focused on Incremental Cost-Effectiveness Ratios and Quality-Adjusted Life Years. Results: Of the 49 articles screened, seven studies were eligible for inclusion. These studies provided a detailed economic evaluation of Fruquintinib against Regorafenib, placebo, and best supportive care. Notably, Fruquintinib was cost-effective in the Chinese healthcare setting with an ICER of $26,508 per QALY compared to $35,607 for Regorafenib. However, it did not meet cost-effectiveness thresholds when compared with placebo, with an ICER exceeding three times the GDP per capita in China, reflecting the economic challenges of implementing new cancer treatments. Conclusion: Fruquintinib shows promise as a cost-effective treatment for metastatic colorectal cancer, particularly in healthcare settings like China, providing significant QALY gains compared to traditional therapies. However, its adoption is highly dependent on local economic thresholds and healthcare systems. While this study underscores the need to integrate economic and clinical outcomes in cancer treatment decisions, the drug's approval and data are currently limited to China, making it difficult to conclude its cost-effectiveness globally