{"title":"Lenvatinib和Sorafenib在伊朗不可切除的肝细胞癌中的成本-效用分析。","authors":"Mohammad Mahdi Raeis Zadeh, Behzad Fatemi, Neshaut Mashreghi Mohammadi, Fatemeh Soleymani","doi":"10.1080/14737167.2025.2543465","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Research design and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-8"},"PeriodicalIF":1.5000,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cost-utility analysis of Lenvatinib vs. Sorafenib in unresectable hepatocellular carcinoma in Iran.\",\"authors\":\"Mohammad Mahdi Raeis Zadeh, Behzad Fatemi, Neshaut Mashreghi Mohammadi, Fatemeh Soleymani\",\"doi\":\"10.1080/14737167.2025.2543465\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Research design and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":12244,\"journal\":{\"name\":\"Expert Review of Pharmacoeconomics & Outcomes Research\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-08-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Pharmacoeconomics & Outcomes Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14737167.2025.2543465\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Pharmacoeconomics & Outcomes Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14737167.2025.2543465","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Cost-utility analysis of Lenvatinib vs. Sorafenib in unresectable hepatocellular carcinoma in Iran.
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.
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.
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