TABLE I.

The Table Demonstrates Several Examples of Cancer Drugs Compared to Standards Used in a Variety of Tumors

Intervention	Comparator	ICER/QALY	Disease	Overall survival (OS) benefit	References
Regorafenib	Best supportive care	$734,153	Colon cancer	1.4 months	Goldstein [38]
Bevacizumab	Paclitaxel	$745,000	Breast cancer	No OS benefit	Montero [39]
Cetuximab	FOLFOX + Bevacizumab	$122,610	Colon cancer	5.7 months	Shankaran [40]
Imatinib	Physician choice tyrosine kinase inhibitor	$227,136	Chronic myeloid leukemia	No OS benefit	Larson [41]
Erlotinib	Gemcitabine	$410,000	Pancreatic cancer	0.33 months	Miksad [42]
Vemurafenib	Dacarbazine	$353,993	Melanoma	3.9 months	Curl [43]
Ixazomib	Lenalidomide + Dexamethasone	$433,794	Multiple myeloma	Not available yet	Institute of Clinical and Economic Review [44]
FOLFOX	FOLFIRI	$65,170	Colorectal cancer	5 months	Tumeh [45]

Using ICER (Incremental cost-effectiveness ratio) divided by QALY (Quality adjusted life year) gives an estimated cost given the known benefit of therapy, with quality of life taken into account, of each intervention compared to the comparator. It has been proposed, that in order for a therapy to be beneficial, that the ICER cost be below the QALY. The examples provided highlight that this is not the case in many interventions and are in fact, not cost effective given the small benefit.