Time to Treatment Discontinuation and Cost Effectiveness of Third-Line Therapies in Advanced Colorectal Cancer: Real-World Evidence from the NIH All of Us Research Program

In this exploratory analysis using the novel NIH All of Us Research Program, ICI therapy was associated with longer treatment duration and greater QALYs but substantially higher costs compared with Rego/Tri. ICI was unlikely to be cost effective at conventional US thresholds but may be favorable at higher willingness-to-pay values. These findings highlight both the promise of leveraging the All of Us Research Program for nationally distributed, demographically diverse pharmacoeconomic research and the challenges of interpreting real-world cost effectiveness in small cohorts. As the dataset matures and sample sizes increase, broader application of All of Us may provide valuable insights to inform precision oncology policy and value-based pricing strategies.