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比较索托拉西布与多西他赛治疗既往治疗的携带 KRASG12C 突变的中国 NSCLC 患者的疗效:一项药物定价的成本效益分析。

Comparison Between Sotorasib with Docetaxel for the Treatment of Chinese Patients with Previously Treated NSCLC with KRASG12C Mutation: A Cost-Effectiveness Analysis to Inform Drug Pricing.

机构信息

Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China.

PET-CT Center, The Second Xiangya Hospital of Central South University, Changsha, China.

出版信息

Adv Ther. 2024 Aug;41(8):3159-3172. doi: 10.1007/s12325-024-02908-8. Epub 2024 Jun 18.


DOI:10.1007/s12325-024-02908-8
PMID:38888881
Abstract

INTRODUCTION: This study sought to investigate the affordable price of sotorasib among patients with previously treated advanced KRASG12C-mutant non-small cell lung cancer (NSCLC) through a cost-effectiveness analysis from the perspectives of both the Chinese healthcare system and the patients. METHODS: We developed a Markov model spanning a 20-year time horizon with a cycle length of 21 days. Our data were derived from the CodeBreaK 200 clinical trial, supplemented with published literature, publicly available national databases, and local hospitals. The primary outcomes were the affordable prices of sotorasib which would result in the incremental cost-effectiveness ratios (ICERs) of sotorasib relative to docetaxel below the preset willing-to-pay (WTP) threshold. Sensitivity analyses were performed to evaluate the model's robustness. RESULTS: At the national level, from the perspective of the Chinese healthcare system and patients, the price of sotorasib should be lower than US$0.04673 and $0.03231, respectively, to make it affordable, which is equivalent to $1346 and $931 per box (120 mg × 240 pieces). At the provincial level, the price ceiling of sotorasib/mg fluctuated between $0.04084 to $0.08061 from the Chinese healthcare system's perspective and between $0.02642 to $0.06620 from the patients' perspective. Probabilistic sensitivity analyses revealed that, as the price of sotorasib decreased, its likelihood of being cost-effective increased. CONCLUSION: Sotorasib might be a cost-effective therapy in China. The pharmaco-economic evidence generated from this study has significant implications not only for guiding the drug pricing of the upcoming sotorasib but also for determining the reimbursement ratio for its potential inclusion in the National Reimbursement Drugs List in the future.

摘要

介绍:本研究旨在从中国医疗保健系统和患者角度出发,通过成本效益分析,探讨先前治疗过的晚期 KRASG12C 突变型非小细胞肺癌(NSCLC)患者可负担的索托拉西布价格。

方法:我们建立了一个 20 年时间跨度的 Markov 模型,每个周期为 21 天。我们的数据来自 CodeBreaK 200 临床试验,并结合了已发表的文献、公开的国家数据库和当地医院的数据。主要结果是索托拉西布的可负担价格,其相对于多西他赛的增量成本效益比(ICER)低于预设的支付意愿(WTP)阈值。进行了敏感性分析以评估模型的稳健性。

结果:从中国医疗保健系统和患者的角度来看,在全国范围内,要使索托拉西布具有可负担性,其价格应分别低于 0.04673 美元和 0.03231 美元,相当于每盒(120mg×240 片)1346 美元和 931 美元。在省级层面,从中国医疗保健系统的角度来看,索托拉西布/毫克的价格上限在 0.04084 美元至 0.08061 美元之间,从患者的角度来看,价格上限在 0.02642 美元至 0.06620 美元之间。概率敏感性分析表明,随着索托拉西布价格的降低,其具有成本效益的可能性增加。

结论:在中国,索托拉西布可能是一种具有成本效益的治疗方法。本研究产生的药物经济学证据不仅对指导即将上市的索托拉西布的药物定价具有重要意义,而且对确定其未来纳入国家医保目录的报销比例也具有重要意义。

相似文献

[1]
Comparison Between Sotorasib with Docetaxel for the Treatment of Chinese Patients with Previously Treated NSCLC with KRASG12C Mutation: A Cost-Effectiveness Analysis to Inform Drug Pricing.

Adv Ther. 2024-8

[2]
Sotorasib versus Docetaxel for treatment of US and Chinese patients with advanced non-small-cell lung cancer with KRAS p.G12C-mutated: A cost-effectiveness analysis to inform drug pricing.

Medicine (Baltimore). 2023-12-15

[3]
Patient-reported outcomes in CodeBreaK 200: Sotorasib versus docetaxel for previously treated advanced NSCLC with KRAS G12C mutation.

Lung Cancer. 2024-10

[4]
Cost-effectiveness of Osimertinib as a Second-line Treatment in Patients With EGFR-mutated Advanced Non-Small Cell Lung Cancer in China.

Clin Ther. 2019-10-10

[5]
Nivolumab Versus Docetaxel for Previously Treated Advanced Non-Small Cell Lung Cancer in China: A Cost-Effectiveness Analysis.

Clin Drug Investig. 2020-2

[6]
Cost-effectiveness analysis of the tislelizumab versus docetaxel for advanced or metastatic non-small-cell lung cancer in China.

Front Public Health. 2024

[7]
Cost-effectiveness of sotorasib as a second-line treatment for non-small cell lung cancer with KRASG mutation in China and the United States.

Front Pharmacol. 2024-6-14

[8]
Targeted Therapies for Previously "Undruggable" KRAS-Mutated Non-Small Cell Lung Cancer: A Review of Sotorasib and Adagrasib.

Ann Pharmacother. 2024-6

[9]
Gene-guided gefitinib switch maintenance therapy for patients with advanced EGFR mutation-positive non-small cell lung cancer: an economic analysis.

BMC Cancer. 2013-1-29

[10]
Cost-effectiveness analysis of first-line treatments for advanced epidermal growth factor receptor-mutant non-small cell lung cancer patients.

Cancer Med. 2021-3

本文引用的文献

[1]
Sotorasib versus docetaxel for previously treated non-small-cell lung cancer with KRAS mutation: a randomised, open-label, phase 3 trial.

Lancet. 2023-3-4

[2]
Impact of the national drug price negotiation policy on the utilization, cost, and accessibility of anticancer medicines in China: A controlled interrupted time series study.

J Glob Health. 2022-12-17

[3]
Cost-Effectiveness of Tepotinib Versus Capmatinib for the Treatment of Adult Patients With Metastatic Non-Small Cell Lung Cancer Harboring Mesenchymal-Epithelial Transition Exon 14 Skipping.

Value Health. 2023-4

[4]
Cost-Effectiveness of First-Line Pembrolizumab Monotherapy Versus Chemotherapy in High Programmed Death-Ligand 1 Advanced Non-Small Cell Lung Cancer in the Irish Healthcare Setting.

Value Health. 2023-3

[5]
Cost-effectiveness analysis of tislelizumab, nivolumab and docetaxel as second- and third-line for advanced or metastatic non-small cell lung cancer in China.

Front Pharmacol. 2022-8-25

[6]
Current cancer burden in China: epidemiology, etiology, and prevention.

Cancer Biol Med. 2022-8-30

[7]
Impacts of National Drug Price Negotiation on Expenditure, Volume, and Availability of Targeted Anti-Cancer Drugs in China: An Interrupted Time Series Analysis.

Int J Environ Res Public Health. 2022-4-11

[8]
Prevalence of KRAS p.(G12C) in stage IV NSCLC patients in the Netherlands; a nation-wide retrospective cohort study.

Lung Cancer. 2022-5

[9]
Targeting KRAS G12C mutation in lung adenocarcinoma.

Lung Cancer. 2022-3

[10]
Sugemalimab versus placebo after concurrent or sequential chemoradiotherapy in patients with locally advanced, unresectable, stage III non-small-cell lung cancer in China (GEMSTONE-301): interim results of a randomised, double-blind, multicentre, phase 3 trial.

Lancet Oncol. 2022-2

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