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fruquintinib 在中国难治性转移性结直肠癌患者中的成本效益分析。

Cost-effectiveness analysis of fruquintinib in Chinese patients with refractory metastatic colorectal cancer.

机构信息

Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, 610041, China.

出版信息

Int J Clin Pharm. 2024 Aug;46(4):872-880. doi: 10.1007/s11096-024-01721-1. Epub 2024 Apr 20.

Abstract

BACKGROUND

Colorectal cancer is a significant health concern worldwide, with metastatic CRC (mCRC) presenting a particularly challenging prognosis. The FRESCO-2 trial highlighted the potential of fruquintinib in heavily pretreated mCRC patients.

AIM

Given the recent changes in drug pricing in China and the evolving mCRC treatments, this study aimed to evaluate the cost-effectiveness of fruquintinib in the context of current Chinese healthcare standards.

METHOD

This study utilized data from the FRESCO-2 trial, incorporating a partitioned-survival model to simulate three health states: Progression-Free Survival, Progressive Disease, and death. Costs and utility values were derived from published literature and the FRESCO-2 trial. Sensitivity analyses were conducted to assess the robustness of the base-case result and to understand the impact of various parameters on the ICER.

RESULTS

The base-case analysis revealed a total cost of $11,089.05 for the fruquintinib group and $5,374.48 for the placebo group. The overall QALYs were higher in the fruquintinib group (0.61 QALYs) compared to the placebo group (0.43 QALYs). The ICER was calculated to be $31,747.67 per QALY. Sensitivity analyses identified the utility of progression-free survival, the cost of fruquintinib, and the costs of best supportive care as significant determinants of ICER.

CONCLUSION

Fruquintinib emerges as a promising therapeutic option for refractory mCRC. However, its cost-effectiveness depends on selected willingness-to-pay (WTP) threshold. While the drug's ICER surpasses the WTP based on China's 2022 GDP per capita, it remains below the threshold set at three times the national GDP.

摘要

背景

结直肠癌是全球范围内的一个重大健康问题,转移性结直肠癌(mCRC)的预后尤其具有挑战性。FRESCO-2 试验强调了 fruquintinib 对大量预处理的 mCRC 患者的潜在作用。

目的

鉴于中国最近的药品定价变化和不断发展的 mCRC 治疗方法,本研究旨在根据当前中国医疗保健标准评估 fruquintinib 的成本效益。

方法

本研究利用 FRESCO-2 试验的数据,采用分区生存模型模拟三种健康状态:无进展生存期、疾病进展和死亡。成本和效用值来自已发表的文献和 FRESCO-2 试验。进行了敏感性分析,以评估基本情况结果的稳健性,并了解各种参数对 ICER 的影响。

结果

基础分析显示,fruquintinib 组的总费用为 11089.05 美元,安慰剂组为 5374.48 美元。fruquintinib 组的总体 QALYs 高于安慰剂组(0.61 QALYs)。ICER 计算为每 QALY 31747.67 美元。敏感性分析确定了无进展生存期的效用、fruquintinib 的成本和最佳支持治疗的成本是 ICER 的重要决定因素。

结论

fruquintinib 是难治性 mCRC 的一种有前途的治疗选择。然而,其成本效益取决于选定的支付意愿(WTP)阈值。虽然该药物的 ICER 超过了基于中国 2022 年人均 GDP 的 WTP,但仍低于国家 GDP 三倍的阈值。

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