# Cost-Utility Analysis of Berberine Chemoprevention for Colorectal Cancer After Polypectomy

## TL;DR

This study finds that adding berberine to colonoscopy is the most cost-effective way to prevent colorectal cancer after polypectomy.

## Contribution

The study introduces a novel cost-utility analysis of berberine as a chemopreventive strategy for post-polypectomy colorectal cancer.

## Key findings

- Colonoscopy plus berberine was the most cost-effective strategy with lower costs and higher QALYs.
- Berberine alone was more cost-effective than no intervention but less effective than colonoscopy alone.
- Combining berberine with colonoscopy is recommended for optimal outcomes in postpolypectomy patients.

## Abstract

Background

Chemoprevention, such as berberine, has been developed as an alternative or complementary strategy to colonoscopy surveillance and has shown promise in reducing the morbidity and mortality of colorectal cancer. This study aims to evaluate the cost-effectiveness of berberine for postpolypectomy patients from the US third-party payer.

Methods

A Markov microsimulation model was developed to compare the cost and efficacy of berberine to no intervention, colonoscopy, and the combination of berberine and colonoscopy in postpolypectomy patients.

Results

After simulating 1 million patients, the study found that colonoscopy alone had a mean cost of $16,391 and mean quality-adjusted life-years (QALYs) of 16.03 per patient, whereas adding berberine slightly reduced the mean cost to $15,609 with a mean QALY of 16.05, making it a dominant strategy. Berberine therapy alone was less effective than colonoscopy alone, with a higher mean cost of $37,480 and a mean QALY of 15.32 per patient. However, berberine therapy was found to be a dominant strategy over no intervention.

Conclusions

Adding berberine to colonoscopy is the most cost-saving and effective approach for postpolypectomy patients. For patients who refuse or have limited access to colonoscopy, berberine alone is likely to be a dominant strategy compared to no intervention.