Cost-effectiveness analysis of atezolizumab plus bevacizumab and chemotherapy for the treatment of metastatic, persistent, or recurrent cervical cancer (BEATcc).

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2024-11-04 DOI:10.1080/14737167.2024.2422465

Yixiao Zhu, Fenghao Shi, Huiting Lin, Yingdan Cao, Hongbin Yi, Sheng Han, Xiaoxia Wei

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引用次数: 0

Abstract

Background: The addition of atezolizumab to bevacizumab plus platinum regimen has demonstrated notable improvements in treating metastatic, persistent, or recurrent cervical cancer, but its cost-effectiveness requires further investigation. From a US payer perspective, we aimed to evaluate the cost-effectiveness of atezolizumab plus bevacizumab and chemotherapy vs. standard chemotherapy as a first-line treatment for metastatic, persistent, or recurrent cervical cancer.

Methods: A partitioned survival model based on the data from the BEATcc trial was used to calculate the incremental cost-effectiveness ratio (ICER), using cost and health utility information obtained from literature and publicly accessible databases. One-way and probabilistic sensitivity analyses were performed to evaluate the model's responsiveness to variations in parameters.

Results: The addition of atezolizumab resulted in an additional 0.839 quality-adjusted life years (QALY) at an additional cost of $458,237, leading to an ICER of $545,943/QALY. One-way sensitivity analysis indicated that the cost of atezolizumab had the greatest impact on the ICER, followed by the utility value of progression-free survival (PFS) and follow-up costs. Probabilistic sensitivity analysis showed a 0% cost-effectiveness probability at the current willingness-to-pay (WTP) threshold of $150,000 per QALY.

Conclusion: Adding atezolizumab to chemotherapy is cost-prohibitive in the US and may not be cost-effective for patients.

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阿特珠单抗联合贝伐单抗和化疗治疗转移性、顽固性或复发性宫颈癌（BEATcc）的成本效益分析。

背景：在贝伐单抗加铂方案中加入阿特珠单抗后，治疗转移性、顽固性或复发性宫颈癌的效果明显改善，但其成本效益还需进一步研究。从美国支付方的角度出发，我们旨在评估阿特珠单抗加贝伐单抗和化疗与标准化疗作为转移性、持续性或复发性宫颈癌一线治疗方案的成本效益：方法：利用从文献和可公开访问的数据库中获取的成本和健康效用信息，采用基于 BEATcc 试验数据的分区生存模型计算增量成本效益比 (ICER)。进行了单向和概率敏感性分析，以评估模型对参数变化的反应能力：结果：添加阿特珠单抗可增加0.839质量调整生命年（QALY），额外成本为458,237美元，ICER为545,943美元/QALY。单向敏感性分析表明，阿特珠单抗的成本对ICER的影响最大，其次是无进展生存期（PFS）的效用值和随访成本。概率敏感性分析表明，在目前每QALY 15万美元的支付意愿（WTP）阈值下，成本效益概率为0%：结论：在美国，在化疗的基础上加用阿特珠单抗的成本过高，对患者而言可能不具成本效益。

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.