Cost-effectiveness of lenvatinib compared with sorafenib for the first-line treatment of advanced hepatocellular carcinoma in Australia
| Autor: | Joshua Byrnes, Martin Downes, Tushar Srivastava, Paul Anthony Scuffham, Masnoon Saiyed |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Sorafenib Male medicine.medical_specialty Carcinoma Hepatocellular Cost effectiveness Cost-Benefit Analysis Antineoplastic Agents 030204 cardiovascular system & hematology Health outcomes 030226 pharmacology & pharmacy 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Humans Pharmacology (medical) Survival analysis health care economics and organizations business.industry Phenylurea Compounds Liver Neoplasms Australia Treatment options General Medicine medicine.disease digestive system diseases First line treatment chemistry Hepatocellular carcinoma Quinolines Female Quality-Adjusted Life Years business Lenvatinib medicine.drug |
| ISSN: | 1173-2563 |
| Popis: | Background and Objective\ud \ud In the REFLECT trial, lenvatinib showed superior clinical benefits to sorafenib in terms of progression-free survival and was non-inferior for overall survival in the treatment of advanced hepatocellular carcinoma (HCC). We assessed the cost-effectiveness of lenvatinib compared with sorafenib for patients with advanced HCC in Australia.\ud \ud \ud Method\ud \ud A partitioned-survival model was built to perform a cost-effectiveness analysis comparing lenvatinib and sorafenib from an Australian health-system perspective. Survival curves were obtained from the REFLECT trial and fitted with parametric survival functions for extrapolation purposes beyond the trial follow-up. Cost and quality-adjusted life-years (QALYs) were accrued over the 10-year time horizon of the model. Deterministic and probability sensitivity analysis (PSA) were carried out to verify the validity of the model.\ud \ud \ud Results\ud \ud Lenvatinib incurred higher costs (A$96,325) and superior health outcomes (QALYs: 1.205), while sorafenib had lower costs (A$92,394) and inferior health outcomes (QALYs: 1.086). Thus, lenvatinib yielded an incremental cost-utility ratio of A$33,028/QALY gained. Further, the results of the PSA found that the probability of lenvatinib being cost-effective at a willingness-to-pay threshold of A$50,000/QALY was 64%.\ud \ud \ud Conclusion\ud \ud Our study found that, at current prices, lenvatinib is a cost-effective treatment option compared with sorafenib for the first-line treatment of patients with advanced HCC. |
| Databáze: | OpenAIRE |
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