在索拉非尼基础上进行肝动脉灌注化疗治疗肝细胞癌伴有主要门静脉肿瘤血栓形成具有成本效益

IF 4.2 3区 医学 Q2 ONCOLOGY Journal of Hepatocellular Carcinoma Pub Date : 2024-07-30 DOI:10.2147/jhc.s470470
Qi-Feng Chen, Xiong-Ying Jiang, Yue Hu, Song Chen, Jun-Zhe Yi, Sui-Xing Zhong, Jiong-Liang Wang, Ning Lyu, Ming Zhao
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引用次数: 0

摘要

目的:与单用索拉非尼相比,索拉非尼和肝动脉灌注化疗(SoHAIC)联合治疗晚期肝细胞癌和主要门静脉肿瘤血栓形成(HCC-Vp3-4)患者可提高总生存率。我们的目的是结合中国医疗支付方的观点,评估索拉非尼与索海克治疗HCC-Vp3-4的成本效益:这项药物经济学研究采用马尔可夫模型评估了索海屈与索拉非尼治疗 HCC-Vp3-4 的成本效益。患者特征来自2017年6月至2019年11月期间进行的试验中的个体,成本和健康价值数据来自已发表的文献。本研究的主要结果指标是增量成本效益比(ICER),它表示每质量调整生命年(QALY)的额外成本。每 QALY 的支付意愿(WTP)阈值设定为 30,492.00 美元。此外,还进行了单向敏感性分析和概率敏感性分析,以验证结果的一致性:在基线方案中,索拉非尼产生了 0.42 QALY,成本为 10,507.89 美元,而 SoHAIC 产生了 1.66 QALY,成本为 32,971.56 美元。将 SoHAIC 与索拉非尼进行比较,每 QALY 的 ICER 为 18,237.20 美元,低于每 QALY 的 WTP 临界值。此外,单向敏感性分析表明,尽管变量存在波动,ICER仍保持在WTP阈值以内。在概率敏感性分析中,考虑到各种参数,SoHAIC在WTP阈值下具有成本效益的概率为98.8%:结论:在此次成本效益评估中,从中国支付方的角度观察,SoHAIC在治疗伴有门静脉肿瘤血栓的HCC方面比索拉非尼更具成本效益:HCC、门静脉肿瘤血栓、索拉非尼、HAIC、成本效益
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Additional Hepatic Arterial Infusion Chemotherapy to Sorafenib Was Cost-Effective for Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombosis
Purpose: The combination of sorafenib and hepatic arterial infusion chemotherapy (SoHAIC) has shown to enhance overall survival rates in patients with advanced hepatocellular carcinoma and major portal vein tumor thrombosis (HCC-Vp3-4) compared to sorafenib alone. Our objective was to evaluate the cost-effectiveness of SoHAIC versus sorafenib for the treatment of HCC-Vp3-4, taking into account the viewpoint of Chinese healthcare payers.
Methods: This pharmacoeconomic study employed a Markov model to assess the cost-effectiveness of treating HCC-Vp3-4 with SoHAIC in comparison to sorafenib. The patient characteristics were drawn from individuals from the trial conducted between June 2017 and November 2019, with cost and health value data sourced from published literature. The primary outcome measure in this research was the incremental cost-effectiveness ratio (ICER), which indicates the additional cost per quality-adjusted life year (QALY). The willingness-to-pay (WTP) threshold per QALY was set at &dollar30,492.00. Furthermore, 1-way sensitivity and probabilistic sensitivity analyses were carried out to validate the consistency of the results.
Results: In the baseline scenario, sorafenib resulted in 0.42 QALY at a cost of &dollar10,507.89, while SoHAIC generated 1.66 QALY at a cost of &dollar32,971.56. When comparing SoHAIC to sorafenib, the ICER was &dollar18,237.20 per QALY, which was below the WTP threshold per QALY. Furthermore, the 1-way sensitivity analysis demonstrated that the ICER remained within the WTP threshold despite fluctuations in variables. In the probabilistic sensitivity analysis, SoHAIC had a 98.8% probability of being cost-effective at the WTP threshold, considering a wide range of parameters.
Conclusion: In this cost-effectiveness evaluation, SoHAIC demonstrated cost-effectiveness over sorafenib for HCC with major portal vein tumor thrombosis, as observed from the perspective of a Chinese payer.

Keywords: HCC, portal vein tumor thrombosis, sorafenib, HAIC, Cost-effectiveness
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CiteScore
0.50
自引率
2.40%
发文量
108
审稿时长
16 weeks
期刊最新文献
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