Cost-effectiveness of atezolizumab plus bevacizumab as first-line therapy for metastatic renal cell carcinoma.

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2024-09-01 DOI:10.1080/14737167.2024.2399246

Siying Wang, Ouyang Xie, Meiyu Wu, Heng Xiang, Chongqing Tan, Xiaomin Wan

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引用次数: 0

Abstract

Objectives: Recently, the IMmotion151 trial evaluated the safety and efficacy of atezolizumab plus bevacizumab in metastatic renal cell carcinoma (mRCC) and found that this combination led to longer progression-free survival. However, no studies have evaluated the cost-effectiveness of atezolizumab plus bevacizumab.

Methods: We constructed a Markov model to evaluate the cost-effectiveness of atezolizumab plus bevacizumab, using costs and utilities from the published studies. We set the willingness-to-pay (WTP) threshold at $150,000. One-way and probabilistic sensitivity analyses were performed to ensure that our results were robust. We performed a threshold analysis to explore a more appropriate price for atezolizumab.

Results: Our results found that although atezolizumab plus bevacizumab provided more quality-adjusted life years (QALYs), its incremental cost-effectiveness ratio (ICER) was $1,640,532/QALY, well above the WTP threshold. One-way and probabilistic sensitivity analysis results confirmed the robust of this conclusion. Based on the threshold analysis, for atezolizumab plus bevacizumab to be cost-effective, the price of them would need to be reduced by 46.3% or more.

Conclusions: From the perspective of US payers, atezolizumab plus bevacizumab is not cost-effective for mRCC patients. To make this combination cost-effective in the future, the price of atezolizumab and bevacizumab needs to be reduced.

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阿特珠单抗联合贝伐单抗作为转移性肾细胞癌一线疗法的成本效益。

研究目的最近，IMmotion151试验评估了atezolizumab联合贝伐珠单抗治疗转移性肾细胞癌（mRCC）的安全性和有效性，发现这种联合治疗可延长无进展生存期。然而，还没有研究对阿特珠单抗联合贝伐单抗的成本效益进行评估：我们利用已发表研究的成本和效用构建了一个马尔可夫模型，以评估阿特珠单抗联合贝伐珠单抗的成本效益。我们将支付意愿（WTP）阈值设定为 15 万美元。我们进行了单向和概率敏感性分析，以确保结果的稳健性。我们进行了阈值分析，以探讨阿特珠单抗更合适的价格：我们的结果发现，虽然atezolizumab加贝伐单抗可提供更多的质量调整生命年（QALY），但其增量成本效益比（ICER）为1,640,532美元/QALY，远高于WTP阈值。单向和概率敏感性分析结果证实了这一结论的可靠性。根据阈值分析，要使阿特珠单抗加贝伐单抗具有成本效益，它们的价格需要降低46.3%或更多：结论：从美国支付方的角度来看，阿特珠单抗加贝伐单抗治疗 mRCC 患者并不划算。要使这一组合在未来具有成本效益，就需要降低阿特珠单抗和贝伐单抗的价格。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Pharmacoeconomics & Outcomes Research HEALTH CARE SCIENCES & SERVICES-PHARMACOLOGY & PHARMACY

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Expert Review of Pharmacoeconomics & Outcomes Research (ISSN 1473-7167) provides expert reviews on cost-benefit and pharmacoeconomic issues relating to the clinical use of drugs and therapeutic approaches. Coverage includes pharmacoeconomics and quality-of-life research, therapeutic outcomes, evidence-based medicine and cost-benefit research. All articles are subject to rigorous peer-review. The journal adopts the unique Expert Review article format, offering a complete overview of current thinking in a key technology area, research or clinical practice, augmented by the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.