Fang Nan, Xia Xuan, He Xiaoning
School of Pharmaceutical Science and Technology, Faculty of Medicine, Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
Expert Rev Pharmacoecon Outcomes Res. 2025 Mar 12:1-10. doi: 10.1080/14737167.2025.2478241.
Chemotherapy-induced myelosuppression (CIM) is the most common adverse event associated with chemotherapy. The recently approved novel pharmacotherapy trilaciclib demonstrates potential to provide multilineage protection against CIM. This study aimed to evaluate the cost-effectiveness of trilaciclib among patients with extensive-stage small cell lung cancer (ES-SCLC) in China.
A short-term Markov model and long-term partitioned survival model were developed to simulate disease progression during and after chemotherapy over a lifetime horizon. Clinical, cost, and utility parameters were obtained from three pivotal clinical trials of trilaciclib, published literature, and expert opinion. Total cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated. Scenario analyses and sensitivity analyses assessed model robustness.
The lifetime incremental cost per patient for trilaciclib was CN¥22,828 (US$3,210), with an incremental QALY of 0.093, yielding an ICER of CN¥245,841 (US$34,565) per QALY gained. This ICER falls below China's willingness-to-pay threshold of three times per-capita GDP (CN¥268,074, US$37,691). Extensive sensitivity analyses confirmed the robustness of the base-case findings.
Trilaciclib represents a cost-effective option for reducing the incidence of CIM in ES-SCLC patients. These results support reimbursement decisions and pricing strategies for trilaciclib in China.
化疗引起的骨髓抑制(CIM)是与化疗相关的最常见不良事件。最近获批的新型药物曲拉西利显示出对CIM提供多谱系保护的潜力。本研究旨在评估曲拉西利在中国广泛期小细胞肺癌(ES-SCLC)患者中的成本效益。
建立了短期马尔可夫模型和长期分区生存模型,以模拟化疗期间及化疗后一生的疾病进展。临床、成本和效用参数来自曲拉西利的三项关键临床试验、已发表的文献以及专家意见。计算了总成本、质量调整生命年(QALY)和增量成本效益比(ICER)。情景分析和敏感性分析评估了模型的稳健性。
曲拉西利每位患者一生的增量成本为22,828元人民币(3,210美元),增量QALY为0.093,每获得一个QALY的ICER为245,841元人民币(34,565美元)。该ICER低于中国三倍人均GDP的支付意愿阈值(268,074元人民币,37,691美元)。广泛的敏感性分析证实了基线结果的稳健性。
曲拉西利是降低ES-SCLC患者CIM发生率的一种具有成本效益的选择。这些结果支持中国曲拉西利的报销决策和定价策略。