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Cost-effectiveness analysis of bevacizumab for cerebral radiation necrosis treatment based on real-world utility value in China.
Luo, Shaohong; Lai, Shufei; Wu, Yajing; Hong, Jinsheng; Lin, Dong; Lin, Shen; Huang, Xiaoting; Xu, Xiongwei; Weng, Xiuhua.
Afiliação
  • Luo S; Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 350004, Fuzhou, China.
  • Lai S; Department of Pharmacy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, 350212, Changle, Fujian Province, China.
  • Wu Y; Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 350004, Fuzhou, China.
  • Hong J; Department of Pharmacy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, 350212, Changle, Fujian Province, China.
  • Lin D; School of Pharmacy, Fujian Medical University, Fuzhou, China.
  • Lin S; Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, 350004, Fuzhou, China.
  • Huang X; Department of Pharmacy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, 350212, Changle, Fujian Province, China.
  • Xu X; School of Pharmacy, Fujian Medical University, Fuzhou, China.
  • Weng X; Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, 350004, Fuzhou, China.
Strahlenther Onkol ; 200(9): 805-814, 2024 Sep.
Article em En | MEDLINE | ID: mdl-38829437
ABSTRACT

BACKGROUND:

Bevacizumab shows superior efficacy in cerebral radiation necrosis (CRN) therapy, but its economic burden remains heavy due to the high drug price. This study aims to evaluate the cost-effectiveness of bevacizumab for CRN treatment from the Chinese payers' perspective.

METHODS:

decision tree model was developed to compare the costs and health outcomes of bevacizumab and corticosteroids for CRN therapy. Efficacy and safety data were derived from the NCT01621880 trial, which compared the effectiveness and safety of bevacizumab monotherapy with corticosteroids for CRN in nasopharyngeal cancer patients, and demonstrated that bevacizumab invoked a significantly higher response than corticosteroids (65.5% vs. 31.5%, P < 0.001) with no significant differences in adverse events between two groups. The utility value of the "non-recurrence" status was derived from real-world data. Costs and other utility values were collected from an authoritative Chinese network database and published literature. The primary outcomes were total costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). The uncertainty of the model was evaluated via one-way and probabilistic sensitivity analyses.

RESULTS:

Bevacizumab treatment added 0.12 (0.48 vs. 0.36) QALYs compared to corticosteroid therapy, along with incremental costs of $ 2010 ($ 4260 vs. $ 2160). The resultant ICER was $ 16,866/QALY, which was lower than the willingness-to-pay threshold of $ 38,223/QALY in China. The price of bevacizumab, body weight, and the utility value of recurrence status were the key influential parameters for ICER. Probabilistic sensitivity analysis revealed that the probability of bevacizumab being cost-effectiveness was 84.9%.

CONCLUSION:

Compared with corticosteroids, bevacizumab is an economical option for CRN treatment in China.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Lesões por Radiação / Análise Custo-Benefício / Anos de Vida Ajustados por Qualidade de Vida / Bevacizumab Limite: Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: Strahlenther Onkol Assunto da revista: NEOPLASIAS / RADIOTERAPIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Lesões por Radiação / Análise Custo-Benefício / Anos de Vida Ajustados por Qualidade de Vida / Bevacizumab Limite: Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: Strahlenther Onkol Assunto da revista: NEOPLASIAS / RADIOTERAPIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China