Cost-utility analysis of Lenvatinib vs. Sorafenib in unresectable hepatocellular carcinoma in Iran.

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-08-07 DOI:10.1080/14737167.2025.2543465

Mohammad Mahdi Raeis Zadeh, Behzad Fatemi, Neshaut Mashreghi Mohammadi, Fatemeh Soleymani

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引用次数: 0

Abstract

Background: Hepatocellular carcinoma (HCC) is a global health issue and the third leading cause of cancer-related deaths. For patients with unresectable HCC (uHCC), Sorafenib and Lenvatinib, are key treatments. This study evaluates the cost-effectiveness of Lenvatinib versus Sorafenib for uHCC in Iran.

Research design and methods: A model-based cost-utility analysis was conducted using a Partitioned Survival Analysis (PartSA) model from the perspective of the Iranian society. Clinical data were sourced from the REFLECT trial, while cost inputs, including treatment, monitoring, and side-effect management, were derived from local healthcare data and expert consultations. Sensitivity analyses and Monte Carlo simulations ensured robustness.

Results: The base-case analysis revealed that Lenvatinib, with a total cost of $9,607, offers a cost saving of $1,551 compared to Sorafenib ($11,158). Lenvatinib also provides an incremental gain of 0.14 Quality-Adjusted Life Years (QALYs) per patient over a 20-years. Probabilistic sensitivity analysis showed a > 99% probability of Lenvatinib being cost-effective. One-way analysis confirmed Lenvatinib's cost-effectiveness if priced below $18/day.

Conclusions: Lenvatinib is a cost-effective alternative to Sorafenib for uHCC treatment in Iran, providing better clinical outcomes and cost savings. These results support its adoption as the preferred treatment, emphasizing the importance of integrating cost-effectiveness analyses into healthcare decision-making.

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Lenvatinib和Sorafenib在伊朗不可切除的肝细胞癌中的成本-效用分析。

背景：肝细胞癌（HCC）是一个全球性的健康问题，也是癌症相关死亡的第三大原因。对于不可切除的HCC （uHCC）患者，索拉非尼和Lenvatinib是关键治疗方法。本研究评估了Lenvatinib与索拉非尼治疗伊朗原发性肝癌的成本-效果。研究设计和方法：从伊朗医疗保健支付者的角度出发，使用分区生存分析（PartSA）模型进行了基于模型的成本效用分析。临床数据来自REFLECT试验，而成本投入，包括治疗、监测和副作用管理，则来自当地医疗保健数据和专家咨询。灵敏度分析和蒙特卡罗模拟确保了鲁棒性。结果：基本病例分析显示，Lenvatinib的总成本为9607美元，与索拉非尼（11158美元）相比，可节省1551美元的成本。Lenvatinib还在20年期间为每位患者提供0.14质量调整生命年（QALYs）的增量增益。概率敏感性分析显示Lenvatinib具有成本效益的概率为0.99%。单向分析证实，如果价格低于18美元/天，Lenvatinib具有成本效益。结论：Lenvatinib是一种具有成本效益的替代索拉非尼治疗伊朗原发性肝癌，提供更好的临床结果和节省成本。这些结果支持将其作为首选治疗方法，强调将成本效益分析纳入医疗保健决策的重要性。

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.