Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.
Expert Rev Pharmacoecon Outcomes Res. 2022 Oct;22(7):1117-1126. doi: 10.1080/14737167.2022.2107506. Epub 2022 Aug 3.
HLX02 is a newly marketed trastuzumab biosimilar in China, but whether its price reflects a potential benefit in terms of its value remains unclear. In addition, the development of biosimilars in China is just beginning, and the state encourages health economic evaluation of newly marketed biosimilars.
Based on the previously published randomized controlled trial data, a Markov model was used to perform health economic evaluation of HLX02 and trastuzumab in the treatment of HER2-positive recurrent or metastatic breast cancer, calculate quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER), and evaluate the robustness of the model with sensitivity analysis.
The model results showed that the 5-year mortality rate was 84.4% in the HLX02 group, while the mortality rate was 91.2% in the trastuzumab group. When without accounting for the cost of second-line treatment, patients treated with HLX02 had an increased life expectancy of 0.138 QALYs and a $421.11 lower cost compared with patients in the trastuzumab group, with an ICER value of -$3,051.52/QALY.
At the willingness-to-pay threshold of $37,653/QALY in China, HLX02 is more cost-effective than trastuzumab. However, the relevant systems for the regulation of biosimilars still need to be improved.
HLX02 是中国新上市的曲妥珠单抗生物类似药,但它的价格是否反映了其在价值方面的潜在获益尚不清楚。此外,中国生物类似药的发展才刚刚开始,国家鼓励对新上市的生物类似药进行卫生经济评价。
基于先前发表的随机对照试验数据,使用马尔可夫模型对 HLX02 和曲妥珠单抗治疗 HER2 阳性复发性或转移性乳腺癌进行卫生经济评价,计算质量调整生命年(QALYs)和增量成本效益比(ICER),并通过敏感性分析评估模型的稳健性。
模型结果显示,HLX02 组的 5 年死亡率为 84.4%,而曲妥珠单抗组的死亡率为 91.2%。在不考虑二线治疗成本的情况下,与曲妥珠单抗组相比,HLX02 组患者的预期寿命增加了 0.138 QALYs,成本降低了 421.11 美元,ICER 值为-3051.52 美元/QALY。
在中国 37653 美元/QALY 的意愿支付阈值下,HLX02 比曲妥珠单抗更具成本效益。然而,生物类似药监管相关制度仍需完善。