美国治疗难治性转移性结直肠癌的 Fruquintinib 成本效益。

IF 2 Q2 ECONOMICS
Dong-Won Kang, Patricio B Lynn, Li Wang, Shouhao Zhou, Chan Shen
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引用次数: 0

摘要

研究背景FRESCO-2试验证实了弗鲁喹替尼对难治性转移性结直肠癌患者的疗效和安全性。然而,该药在美国的成本效益并没有得到很好的证实:本研究从美国支付方的角度出发,评估了该患者群体使用 fruquintinib 与安慰剂的成本效益:我们根据从 FRESCO-2 试验的生存曲线中重建的患者水平数据开发了一个分区生存模型。我们进行了参数估计,以估算患者一生中的长期临床结果和医疗费用。成本投入和效用来自公共数据和以往文献。我们对临床结果和成本采用了每年 3.0% 的贴现率。我们采用的增量成本效益比(ICER)阈值为每质量调整生命年(QALY)收益 100,000 美元。我们进行了敏感性分析和情景分析,以检验成本效益结果的稳健性:与安慰剂相比,福喹替尼治疗可带来 0.108 个生命年和 0.073 个质量调整生命年的增量收益,额外费用为 112,294 美元,主要由药物费用驱动。经计算,与安慰剂相比,fruquintinib的ICER为每LYs 1,037,855美元,每QALY获得1,546,619美元,超过了预定义的成本效益阈值。在所有敏感性和情景分析中,成本效益结果都是稳健的:在美国,尽管弗鲁喹替尼对难治性转移性结直肠癌患者有生存获益,但根据传统的支付意愿阈值,弗鲁喹替尼与安慰剂相比并不具有成本效益。我们的研究结果可为fruquintinib的定价和报销决策提供依据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-Effectiveness of Fruquintinib for Refractory Metastatic Colorectal Cancer in the USA.

Background: The FRESCO-2 trial established the efficacy and safety of fruquintinib in patients with refractory metastatic colorectal cancer. However, its cost-effectiveness in the US context is not well documented.

Objective: This study evaluates the cost-effectiveness of fruquintinib versus placebo for this patient population from the perspective of US payers.

Methods: We developed a partitioned survival model on the basis of patient-level data reconstructed from the survival curves of the FRESCO-2 trial. Parametric estimation was conducted to estimate long-term clinical outcomes and medical costs over a lifetime horizon. Cost inputs and utilities were sourced from public data and previous literature. We used a discount rate of 3.0% per year for both clinical outcomes and costs. We adopted an incremental cost-effectiveness ratio (ICER) threshold of US$100,000 per quality-adjusted life-year (QALY) gained. We performed sensitivity and scenario analyses to examine the robustness of cost-effectiveness results.

Results: Fruquintinib treatment resulted in incremental gains of 0.108 life years (LYs) and 0.073 QALYs compared with the placebo, at an additional cost of US$112,294, primarily driven by medication expenses. The ICER for fruquintinib versus placebo was calculated at US$1,037,855 per LY and US$1,546,619 per QALY gained, exceeding the predefined cost-effectiveness threshold. The cost-effectiveness results were robust across all sensitivity and scenario analyses.

Conclusion and relevance: Despite the survival benefit, fruquintinib was not cost-effective compared with the placebo in patients with refractory metastatic colorectal cancer in the US setting, on the basis of the conventional willingness-to-pay threshold. Our findings may provide a basis for informing the pricing and reimbursement decisions regarding fruquintinib.

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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
64
审稿时长
8 weeks
期刊介绍: PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.
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