Liu Ruizhe, Qiu Kaifeng, Wu Junyan, Jiang Yanqing, Wu Peihao, Pang Jianxin
Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangdong Guangzhou, 510515, China.
Department of Pharmacy, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510030, China.
Immunotherapy. 2022 Aug;14(11):859-869. doi: 10.2217/imt-2021-0156. Epub 2022 Jun 27.
To evaluate the cost-effectiveness of first-line treatment for advanced renal cell carcinoma with nivolumab plus cabozantinib versus sunitinib from a US payer perspective. Economic outcomes were estimated with Markov and partitioned survival models. Efficacy, safety and other data were taken from the CheckMate 9ER trial. Costs and utilities were gathered from published sources. Sensitivity analyses addressed model uncertainties. The incremental cost-effectiveness ratio of nivolumab plus cabozantinib versus sunitinib was US$555,663 and $531,748 per quality-adjusted life year in the Markov and partitioned survival models, respectively, exceeding the willingness-to-pay threshold (US$150,000 per quality-adjusted life-year). Sensitivity analyses showed robust outcomes. From a US payer perspective, first-line nivolumab plus cabozantinib for advanced renal cell carcinoma is not cost effective.
从美国医保支付方的角度评估纳武利尤单抗联合卡博替尼与舒尼替尼用于晚期肾细胞癌一线治疗的成本效益。采用马尔可夫模型和分割生存模型估计经济结果。疗效、安全性和其他数据取自CheckMate 9ER试验。成本和效用数据来自已发表的资料。敏感性分析解决了模型的不确定性问题。在马尔可夫模型和分割生存模型中，纳武利尤单抗联合卡博替尼相对于舒尼替尼的增量成本效益比分别为每质量调整生命年555,663美元和531,748美元，超过了支付意愿阈值（每质量调整生命年150,000美元）。敏感性分析显示结果稳健。从美国医保支付方的角度来看，纳武利尤单抗联合卡博替尼用于晚期肾细胞癌的一线治疗不具有成本效益。
