安罗替尼对比舒尼替尼用于中国转移性肾细胞癌一线治疗的成本效果分析。
Cost-effectiveness analysis of anlotinib versus sunitinib as first-line treatment for metastatic renal cell carcinoma in China.
机构信息
Department of Cardiovascular Medicine, Heart Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
Department of Pharmacy, Center for Clinical Pharmacy, Cancer Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
出版信息
PLoS One. 2023 Feb 7;18(2):e0281402. doi: 10.1371/journal.pone.0281402. eCollection 2023.
BACKGROUND
Sunitinib was approved several years ago as a first-line drug for treating metastatic renal cell carcinoma (mRCC); however, its high price and broad side effects when administered at the standard dose have limited its clinical use. A clinical trial (NCT02072031) confirmed that anlotinib could be used as the first-line treatment for mRCC. This study was conducted to evaluate the cost-effectiveness of anlotinib as a first-line treatment for mRCC compared to that of sunitinib in China.
METHODS
A Markov model was established to compare the cost-effectiveness of anlotinib with that of sunitinib. Clinical data were obtained from a multi-center phase II trial (clinical trial information: NCT02072031). Utility values were obtained from the literature. Total costs were calculated from a Chinese societal perspective. A sensitivity analysis was conducted to assess the model uncertainty. The life-year (LY), quality-adjusted life-year (QALY), and incremental cost-effectiveness ratio were calculated.
RESULTS
The base-case analysis over a lifetime horizon of 10 years showed that the anlotinib group had 2.196 LYs and 1.487 QALYs at a total cost of $68,597.84. The sunitinib group had 2.194 LYs and 1.432 QALYs at a total cost of $88,060.02. This resulted in incremental cost-effectiveness ratios (ICER) of anlotinib versus sunitinib of $-9,210,858.93 per LYs and $-354,117.07 per QALYs, suggesting that anlotinib is a more effective and less costly strategy than sunitinib.
CONCLUSION
Anlotinib may be a more cost-effective first-line treatment strategy for mRCC than sunitinib in China.
背景
舒尼替尼数年前被批准用于治疗转移性肾细胞癌（mRCC），作为一线药物；然而，由于标准剂量下该药价格昂贵且副作用广泛，限制了其临床应用。一项临床试验（NCT02072031）证实安罗替尼可作为 mRCC 的一线治疗药物。本研究旨在评估安罗替尼对比舒尼替尼作为中国 mRCC 一线治疗药物的成本效果。
方法
建立 Markov 模型，比较安罗替尼与舒尼替尼作为 mRCC 一线治疗药物的成本效果。临床数据来自多中心 II 期临床试验（临床试验信息：NCT02072031）。效用值来自文献。总成本从中国社会角度进行计算。进行敏感性分析以评估模型不确定性。计算生命年（LY）、质量调整生命年（QALY）和增量成本效果比。
结果
10 年生命周期的基本情况分析显示，安罗替尼组总费用为 68597.84 美元，LY 为 2.196，QALY 为 1.487；舒尼替尼组总费用为 88060.02 美元，LY 为 2.194，QALY 为 1.432。安罗替尼对比舒尼替尼的增量成本效果比（ICER）为 LY 每增加 1 个单位时为-9210858.93 美元，QALY 每增加 1 个单位时为-354117.07 美元，提示安罗替尼是比舒尼替尼更有效、成本更低的策略。
结论
安罗替尼可能是中国 mRCC 一线治疗的更具成本效果的治疗策略。
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