Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for patients with unresectable hepatocellular carcinoma: a cost-utility analysis in China and the United States.

IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY
Frontiers in Pharmacology Pub Date : 2025-05-01 eCollection Date: 2025-01-01 DOI:10.3389/fphar.2025.1404389
Qiuling Zhao, Yimin He, Zilin Nian, Yongjian Huang, Ruyi Huang, Lijun Lai, Lin Yang
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Abstract

Objective: Camrelizumab plus rivoceranib (camr-rivo) has been shown to significantly improve overall survival (OS) in patients with unresectable or advanced hepatocellular carcinoma (HCC) in the CARES-310 trial. However, the cost-utility of this treatment remains unclear. Therefore, this study evaluated the cost-utility of camr-rivo versus sorafenib as a first-line systemic therapy for patients with unresectable or advanced HCC from the perspectives of the Chinese healthcare system and the United States (US) payers.

Methods: Based on the CARES-310 trial, a partitioned survival model was constructed to estimate economic costs and health outcomes over a 10-year lifetime horizon. Drug costs were obtained from the public database, Red Book, and relevant literature. Health utility values were derived from the literature. One-way and probabilistic sensitivity analyses were performed. The willingness-to-pay (WTP) threshold was $36,627.25/QALY in China and $150,000.00/QALY in the United States.

Results: Camr-rivo yielded an additional 0.34 quality-adjusted life years (QALY) compared to sorafenib for patients with unresectable or advanced HCC. The incremental costs in China and the United States were $4,762.10 and $92,700.49, respectively, and the incremental cost-utility ratios (ICURs) were $14,174.40/QALY and $272,852.59/QALY, respectively. Sensitivity analyses indicated that the cost of rivoceranib and camrelizumab had the greatest impact on the ICUR in China and the United States. Scenario analyses showed that a price reduction of approximately 30% for camrelizumab and rivoceranib could make camr-rivo a cost-utility option in the United States.

Conclusion: At the set WTP threshold, camr-rivo is a cost-utility treatment strategy compared to sorafenib as a first-line therapy for patients with unresectable or advanced HCC in China but not in the United States.

Camrelizumab + rivoeranib vs sorafenib作为不可切除肝细胞癌患者的一线治疗:中国和美国的成本-效用分析
目的:在CARES-310试验中,Camrelizumab联合rivoeranib (camr-rivo)已被证明可显着提高不可切除或晚期肝细胞癌(HCC)患者的总生存期(OS)。然而,这种治疗的成本效用仍不清楚。因此,本研究从中国医疗保健系统和美国支付者的角度评估了camr-rivo与索拉非尼作为不可切除或晚期HCC患者一线全身治疗的成本-效用。方法:在CARES-310试验的基础上,构建了一个分区生存模型来估计10年生命周期内的经济成本和健康结果。药品费用来源于公共数据库、红皮书和相关文献。健康效用值来源于文献。进行了单向和概率敏感性分析。支付意愿(WTP)阈值在中国为36,627.25美元/QALY,在美国为150,000.00美元/QALY。结果:Camr-rivo在不可切除或晚期HCC患者中比sorafenib多出0.34质量调整生命年(QALY)。中国和美国的增量成本分别为4,762.10美元和92,700.49美元,增量成本效用比(ICURs)分别为14,174.40美元/QALY和272,852.59美元/QALY。敏感性分析表明,在中国和美国,利维拉尼和camrelizumab的成本对ICUR的影响最大。情景分析显示,camrelizumab和rivoeranib的价格降低约30%,可能使camr-rivo在美国成为成本效用选择。结论:在设定的WTP阈值下,与索拉非尼相比,camr-rivo作为不可切除或晚期HCC患者的一线治疗策略在中国是一种成本-效用治疗策略,但在美国不是。
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
Frontiers in Pharmacology
Frontiers in Pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
7.80
自引率
8.90%
发文量
5163
审稿时长
14 weeks
期刊介绍: Frontiers in Pharmacology is a leading journal in its field, publishing rigorously peer-reviewed research across disciplines, including basic and clinical pharmacology, medicinal chemistry, pharmacy and toxicology. Field Chief Editor Heike Wulff at UC Davis is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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