Department of Pharmacy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.
BMJ Open. 2024 Jul 13;14(7):e073170. doi: 10.1136/bmjopen-2023-073170.
The economic implications of combining rezvilutamide with androgen deprivation therapy (ADT) remain uncertain, despite the observed survival advantages compared with bicalutamide plus ADT. Therefore, this study evaluates the cost-effectiveness of rezvilutamide plus ADT as the first-line treatment of metastatic hormone-sensitive prostate cancer (mHSPC) from the perspective of the Chinese healthcare system.
A partitioned survival model was developed to assess the cost-effectiveness of rezvilutamide combined with ADT. Clinical data were obtained from the CHART trial. Costs and utility values were obtained from local estimate and published literature. Only direct medical costs were included in the model.
Rezvilutamide was administered at 240 mg daily or bicalutamide at 50 mg daily until progression.
The main outputs of the model included costs and quality-adjusted life years (QALYs), which were used to determine the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analysis (PSA) were used to explore model uncertainties.
The rezvilutamide group showed an expected gain of 2.28 QALYs and an incremental cost of US$60 758.82 compared with the bicalutamide group. The ICER for rezvilutamide group versus bicalutamide group was US$26 656.94 per QALY. The variables with the greatest impact on the model results were the utility for progression-free survival state and the price of rezvilutamide. PSA revealed that rezvilutamide group had 100% probability of being cost-effective at a willingness-to-pay threshold of US$35707.5 per QALY.
Rezvilutamide in combination with ADT is more cost-effective compared with bicalutamide plus ADT as the first-line treatment of mHSPC from the perspective of the Chinese healthcare system.
尽管与比卡鲁胺联合 ADT 相比，观察到 Rezvilutamide 具有生存优势，但联合 Rezvilutamide 与雄激素剥夺疗法（ADT）的经济意义仍不确定。因此，本研究从中国医疗保健系统的角度评估 Rezvilutamide 联合 ADT 作为转移性激素敏感前列腺癌（mHSPC）一线治疗的成本效益。
开发了一个分区生存模型来评估 Rezvilutamide 联合 ADT 的成本效益。临床数据来自 CHART 试验。成本和效用值来自当地估计和已发表的文献。模型中仅包括直接医疗成本。
每天给予 Rezvilutamide 240mg 或比卡鲁胺 50mg，直至进展。
模型的主要输出包括成本和质量调整生命年（QALYs），用于确定增量成本效益比（ICER）。采用单因素和概率敏感性分析（PSA）来探讨模型的不确定性。
与比卡鲁胺组相比， Rezvilutamide 组预计可获得 2.28 个 QALYs 和 60758.82 美元的增量成本。 Rezvilutamide 组与比卡鲁胺组的 ICER 为 26656.94 美元/QALY。对模型结果影响最大的变量是无进展生存状态的效用和 Rezvilutamide 的价格。PSA 表明，在愿意支付的阈值为 35707.5 美元/QALY 时， Rezvilutamide 组有 100%的可能性具有成本效益。
从中国医疗保健系统的角度来看， Rezvilutamide 联合 ADT 作为 mHSPC 的一线治疗，比卡鲁胺联合 ADT 更具成本效益。
