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在中国使用分区生存模型对古玛替尼与赛沃替尼治疗具有MET外显子14跳跃突变的晚期或转移性非小细胞肺癌的成本效益分析。

Cost-effectiveness analysis of gumarontinib versus savolitinib for the treatment of advanced or metastatic NSCLC with MET exon 14 skipping mutations in China using partitioned survival model.

作者信息

Fang Gang, Pi Zhipeng, An Yiping, Cao Xinxin, Li Wei, Zhu Xiangjun, Ding Jinxi

机构信息

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.

Pharmaceutical Market Access Policy Research Center, China Pharmaceutical University, Nanjing, China.

出版信息

Front Pharmacol. 2025 Jan 24;16:1400422. doi: 10.3389/fphar.2025.1400422. eCollection 2025.

DOI:10.3389/fphar.2025.1400422
PMID:39925845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11802428/
Abstract

BACKGROUND AND OBJECTIVES

Both gumarontinib and savolitinib have demonstrated efficacy in treating non-small-cell lung cancer (NSCLC) with tumors harboring mesenchymal-epithelial transition factor gene exon 14 (METex14) skipping. However, the comparison of their efficacy and pharmacoeconomics profiles remains limited. This study aims to evaluate the cost-effectiveness of gumarontinib versus savolitinib for the treatment of METex14 skipping NSCLC in China.

METHODS

A 3-state partitioned survival model (PSM) was developed with lifetime horizon from the perspective of Chinese healthcare system. Survival inputs were based on an unanchored matching-adjusted indirect comparison using individual patient data from GLORY trial to adjust for patient characteristics in NCT02897479. Costs and outcomes were discounted at an annual rate of 5%. Sensitivity and scenario analyses were conducted to explore model uncertainty.

RESULTS

Gumarontinib gained an additional 0.10 QALYs at an incremental cost of $1,893 compared to savolitinib, resulting in the ICERs of $19,243/QALY, which is below the threshold of 3 times the GDP in China ($35,007 in 2022). Sensitivity and scenario analyses confirmed the robustness of the base-case results.

CONCLUSION

Gumarontinib is a cost-effective option compared to savolitinib for METex14 skipping NSCLC in China.

摘要

背景与目的

古玛替尼和赛沃替尼在治疗具有间充质-上皮转化因子基因第14外显子（METex14）跳跃突变的非小细胞肺癌（NSCLC）方面均已显示出疗效。然而，它们疗效和药物经济学特征的比较仍然有限。本研究旨在评估在中国，古玛替尼与赛沃替尼治疗METex14跳跃突变NSCLC的成本效益。

方法

从中国医疗保健系统的角度出发，建立了一个具有终身视角的三状态分区生存模型（PSM）。生存数据输入基于一项未锚定的匹配调整间接比较，使用GLORY试验的个体患者数据来调整NCT02897479中的患者特征。成本和结局以5%的年贴现率进行贴现。进行了敏感性和情景分析以探索模型的不确定性。

结果

与赛沃替尼相比，古玛替尼以1893美元的增量成本获得了额外的0.10个质量调整生命年（QALY），导致增量成本效果比（ICER）为19243美元/QALY，低于中国国内生产总值三倍的阈值（2022年为35007美元）。敏感性和情景分析证实了基础案例结果的稳健性。

结论

在中国，对于METex14跳跃突变的NSCLC，与赛沃替尼相比，古玛替尼是一种具有成本效益的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/2460855891d6/fphar-16-1400422-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/9e8522cd4e71/fphar-16-1400422-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/f15d02e73a54/fphar-16-1400422-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/3290ef10d778/fphar-16-1400422-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/487639809feb/fphar-16-1400422-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/2460855891d6/fphar-16-1400422-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/9e8522cd4e71/fphar-16-1400422-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/f15d02e73a54/fphar-16-1400422-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/3290ef10d778/fphar-16-1400422-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/487639809feb/fphar-16-1400422-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e137/11802428/2460855891d6/fphar-16-1400422-g005.jpg

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