Economic evaluation of three domestic bevacizumab biosimilars and the original bevacizumab for treating nonsquamous non-small cell lung cancer in china: a cost-effectiveness analysis.
Yu Zhang, Tianqi Zhou, Nan Wu, Zhaoshi Bai, Jifu Wei, Ning Cai, Silu Xu
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引用次数: 0
Abstract
Objective: This study assessed the cost-effectiveness of three domestic bevacizumab biosimilars (IBI305, LY01008, and QL1101) and an originator (Avastin) as first-line treatments for nonsquamous NSCLC in China.
Methods: A network meta-analysis (NMA) using the fractional polynomial (FP) method was used to determine hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) without relying on the proportional hazards (PH) assumption. Adjusted OS and PFS curves were used to compare effects. A partitioned survival model was used to evaluate the cost-effectiveness of the biosimilars plus chemotherapy versus the originator plus chemotherapy. The model included cost, utility parameters, scale, and shape determined from previous studies. Probabilistic sensitivity analysis (PSA) and one-way deterministic sensitivity analysis (DSA) were used to assess uncertainty.
Results: In a baseline study, LY01008 + chemotherapy, QL1101 + chemotherapy, and bevacizumab + chemotherapy were less effective than IBI305 + chemotherapy. Treatment with LY01008 achieved an additional 0.23 quality-adjusted life-years (QALYs), with a higher cost of $817, leading to an incremental cost-effectiveness ratio (ICER) of $3,552/QALY when compared with that of QL1101. All three biosimilars showed better cost-effectiveness than the originator. The DSA results revealed that the HR-related parameters from the NMA and drug price were the primary sources of uncertainty surrounding incremental net monetary benefits (INMBs). PSA showed that the IBI305 was most likely to be cost-effective when the WTP was 1-3 times the per capita GDP of China in 2022. Sensitivity and scenario analysis confirmed the reliability of the fundamental analysis results.
Conclusions: Domestic bevacizumab biosimilars are cost-effective alternatives to first-line treatment for nonsquamous NSCLC in China. IBI305 exhibited the most significant cost-effective advantage among the domestic biosimilars.
期刊介绍：
Cost Effectiveness and Resource Allocation is an Open Access, peer-reviewed, online journal that considers manuscripts on all aspects of cost-effectiveness analysis, including conceptual or methodological work, economic evaluations, and policy analysis related to resource allocation at a national or international level. Cost Effectiveness and Resource Allocation is aimed at health economists, health services researchers, and policy-makers with an interest in enhancing the flow and transfer of knowledge relating to efficiency in the health sector. Manuscripts are encouraged from researchers based in low- and middle-income countries, with a view to increasing the international economic evidence base for health.
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