Cost-effectiveness analysis of trifluridine/tipiracil in the treatment of heavily pretreated metastatic gastric cancer from the perspective of Chinese healthcare system.

Autor:	Ying T; School of Pharmacy, Anhui Medical University, Hefei, Anhui, China.; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China., Xia R; School of Pharmacy, Anhui Medical University, Hefei, Anhui, China.; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China., Zhang Y; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China.; Anhui Provincial Drug Regulatory Scientific Research Center, Anhui Medical University, Hefei, Anhui, China., Dai J; School of Pharmacy, Anhui Medical University, Hefei, Anhui, China.; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China., Wang Y; School of Pharmacy, Anhui Medical University, Hefei, Anhui, China.; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China., Xie X; Anhui Provincial Drug Regulatory Scientific Research Center, Anhui Medical University, Hefei, Anhui, China xiexuefengahmu@126.com.; Key Laboratory of Public Health Social Governance, Philosophy and Social Sciences of Anhui Province, Anhui Medical University, Hefei, Anhui, China.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Nov 07; Vol. 14 (11), pp. e080846. Date of Electronic Publication: 2024 Nov 07.
DOI:	10.1136/bmjopen-2023-080846
Abstrakt:	Objectives: The aim of this study was to evaluate the cost-effectiveness of trifluridine/tipiracil (FTD/TPI) for heavily pretreated metastatic gastric cancer from the perspective of the Chinese healthcare system. Designs: Based on the overall survival and progression-free survival (PFS) data from the Trifluridine/tipiracil versus placebo in patients with heavily pretreated metastatic gastric cancer (TAGS) trial (NCT02500043), a three-state Markov model (PFS, progressed disease and death) was constructed to analyse the cost-effectiveness of FTD/TPI compared with the placebo in heavily pretreated metastatic gastric cancer. Cost and utility were from pricing records and the literature. The model was simulated for 5 years with monthly cycles. Costs and health outcomes were discounted by 5%. We then conducted sensitivity analyses to evaluate the robustness of the parameters. The model results were from the Chinese healthcare system. Outcome Measures: The output results were the quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). Results: According to the model results, FTD/TPI generated an additional cost of US$26 855.66 and 0.88 QALYs compared with the placebo. ICER of FTD/TPI compared with the placebo was US$30 494.89 per QALY. Sensitivity analyses revealed that the utility value of the PFS stage and FTD/TPI adverse event costs were the main influencing parameters, and the results were stable. At a threshold of three times per capita gross domestic product of China (US$35 559.34 in 2022), the probability of FTD/TPI being cost-effective compared with placebo was 99.2%. Conclusion: From the perspective of the Chinese healthcare system, FTD/TPI is a more cost-effective option compared with the placebo for the treatment of heavily pretreated metastatic gastric cancer in patients who have received at least two prior advanced treatment regimens. Trial Registration Number: The Chinese population registered in the Chinese Clinical Trial Registry (ChiCTR2400080940) and clinical trial (NCT05029102). Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu