| Autor: |
Jing Nie, Huina Wu, Huiyue Zhang, Lihui Liu, Qian Wu, Ke Tang, Jiyong Wu |
| Rok vydání: |
2023 |
| DOI: |
10.21203/rs.3.rs-2730149/v1 |
| Popis: |
Background Zanubrutinib is a powerful specific and irreversible bruton tyrosine kinase (BTK) inhibitor. Whether used alone or in combination with other drugs, it is proved to be effective in untreated chronic lymphocytic leukemia (CLL). Here, we compared the cost-effectiveness of zanubrutinib and bendamustine-rituximab (R-bendamustine) to determine its effectiveness as first-line treatment for Chinese patients with untreated CLL. Methods The cost-effectiveness of zanubrutinib and R-bendamustine treatment for CLL was evaluated by a partitioned survival model. It was constructed using TreeAge Pro 2011 software mainly based on the clinical data derived from SEQUOIA. Transition probabilities were estimated from the reported survival probabilities in trials using parametric survival modeling. In this analysis, the quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER) and lifetime cost were calculated from the Chinese healthcare system perspective. An entire life span horizon and annual 5% discounting were used. One-way analysis and probabilistic sensitivity analysis (PSA) were carried to explore the uncertainty of the modeling results. Additionally, several scenarios analysis, including different zanubrutinib price calculation and 20-year time horizon were evaluated. Results The cost of zanubrutinib and R-bendamustine were $98711.7 and $53095.17. Zanubrutinib had an ICER of $58258.18 per additional QALYs gained compared with R- bendamustine. Research indicated that zanubrutinib achieved at least an 3.70% probability of cost-effectiveness at the threshold of $38223.34/QALY. One-way sensitivity analysis revealed that the results were sensitive to utility of PD. Scenario analysis showed that zanubrutinib was cost-effectiveness when its price reduced more than 20%. Conclusions At current price, zanubrutinib was less cost-effectiveness for patients with CLL compared with R-bendamustine in China. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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