# Cost-effectiveness of first-line encorafenib plus cetuximab with mFOLFOX6 in BRAF V600E-mutant metastatic colorectal cancer

## TL;DR

This study finds that a new drug combination for a specific type of colorectal cancer improves survival but is not cost-effective compared to standard treatment.

## Contribution

The study evaluates the cost-effectiveness of a novel targeted therapy combination in BRAF V600E-mutant metastatic colorectal cancer using real clinical trial data.

## Key findings

- Targeted regimens improved survival but were not cost-effective under current pricing.
- Standard chemotherapy was favored as the most cost-effective strategy in probabilistic analysis.
- Early benefit was observed with the combination therapy, but costs outweighed economic value.

## Abstract

Patients with BRAF V600E-mutant metastatic colorectal cancer have poor prognosis, and the value of first-line targeted combination therapies remains uncertain. We evaluated the cost-effectiveness of encorafenib plus cetuximab with or without chemotherapy compared with standard chemotherapy, using clinical outcomes from a phase 3 randomized trial. A partitioned survival model with long-term extrapolation was applied to estimate lifetime costs and health outcomes from a United States payer perspective. Although both targeted regimens improved survival compared with standard chemotherapy, they were associated with substantially higher costs. Consequently, neither targeted strategy was cost-effective at commonly used willingness-to-pay thresholds under current pricing. These findings demonstrate that clinically meaningful survival gains may not translate into economic value in first-line settings. This study underscores the importance of incorporating economic evidence into early treatment adoption decisions and highlights the need for pricing approaches that better align costs with patient benefit.

•First-line EC ± mFOLFOX6 improved survival but was not cost-effective relative to SOC•NNTs showed EC + mFOLFOX6 prevented progression and death, with early benefit•Probabilistic analysis favored SOC as the most cost-effective strategy•Value attribution revealed synergy but economic imbalance between components

First-line EC ± mFOLFOX6 improved survival but was not cost-effective relative to SOC

NNTs showed EC + mFOLFOX6 prevented progression and death, with early benefit

Probabilistic analysis favored SOC as the most cost-effective strategy

Value attribution revealed synergy but economic imbalance between components

Medical economics; pharmaceutical science; medical informatics; cancer; decision science