Wang Lin, Chen Fen, Ma Yuanyuan, Lin Xihan, Liu Jinyu, Zhang Yu, You Ruxu
Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Future Sci OA. 2025 Dec;11(1):2514969. doi: 10.1080/20565623.2025.2514969. Epub 2025 Jun 18.
This study assesses the cost-effectiveness of carfilzomib plus lenalidomide and dexamethasone (KRd) ixazomib plus lenalidomide and dexamethasone for relapsed and refractory multiple myeloma (RRMM) in China.
A survival model was used to analyze health states and costs over a lifetime, with a 4-week cycle. Treatment effects on progression-free survival (PFS) and overall survival (OS) were modeled using hazard ratios (HRs) derived from the network meta-analysis (NMA). Health state utility values and disutility values for adverse events were obtained from published literature. Direct medical costs included drug costs, disease management costs, and costs associated with adverse event management. Costs and utilities were discounted by 5% annually. Both one-way and probabilistic sensitivity analyses were conducted.
The carfilzomib combination was found to be cost-effective, saving $127,513.22 per additional quality-adjusted life year (QALY) gained compared to the ixazomib combination. Sensitivity analysis showed that ixazomib's price, progression state utility, and carfilzomib's price significantly affected the results. At a $40,023.27 willingness-to-pay (WTP) threshold, the carfilzomib combination has a 100% probability of being cost-effective.
The study shows that, based on evidence from indirect comparisons, KRd is a cost-effective treatment option for RRMM patients in China.
本研究评估在中国卡非佐米联合来那度胺和地塞米松（KRd）与伊沙佐米联合来那度胺和地塞米松用于复发难治性多发性骨髓瘤（RRMM）的成本效益。
采用生存模型分析终身健康状态和成本，周期为4周。使用从网络荟萃分析（NMA）得出的风险比（HRs）对治疗对无进展生存期（PFS）和总生存期（OS）的影响进行建模。从已发表的文献中获取健康状态效用值和不良事件的负效用值。直接医疗成本包括药物成本、疾病管理成本以及与不良事件管理相关的成本。成本和效用按每年5%进行贴现。进行了单向和概率敏感性分析。
发现卡非佐米联合方案具有成本效益，与伊沙佐米联合方案相比，每获得一个额外的质量调整生命年（QALY）可节省127,513.22美元。敏感性分析表明，伊沙佐米的价格、进展状态效用以及卡非佐米的价格对结果有显著影响。在支付意愿（WTP）阈值为40,023.27美元时，卡非佐米联合方案具有100%的成本效益概率。
该研究表明，基于间接比较的证据，KRd是中国RRMM患者具有成本效益的治疗选择。
