Cost-effectiveness analysis of lenvatinib treatment for patients with unresectable hepatocellular carcinoma (uHCC) compared with sorafenib in Japan
Autor: | Shunya Ikeda, Mika Ishii, Masahiro Kobayashi, Namiki Izumi, Masatoshi Kudo, Genevieve Meier, Janice Pan, Ronda Copher, Shuichi Kaneko, Mie Azuma |
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Rok vydání: | 2018 |
Předmět: |
Sorafenib
Oncology medicine.medical_specialty Carcinoma Hepatocellular Cost effectiveness Hepatocellular carcinoma Cost-Benefit Analysis Antineoplastic Agents 03 medical and health sciences chemistry.chemical_compound QALY 0302 clinical medicine Pharmacotherapy Japan Internal medicine medicine Humans Lenvatinib Randomized Controlled Trials as Topic Original Article—Liver Pancreas and Biliary Tract business.industry Phenylurea Compounds Liver Neoplasms Gastroenterology Cost-effectiveness analysis medicine.disease Survival Analysis Colorectal surgery Clinical trial Models Economic chemistry 030220 oncology & carcinogenesis Quinolines 030211 gastroenterology & hepatology Cost-effectiveness Quality-Adjusted Life Years business medicine.drug |
Zdroj: | Journal of Gastroenterology |
ISSN: | 1435-5922 |
Popis: | Background Lenvatinib demonstrated a treatment effect on overall survival by the statistical confirmation of non-inferiority to sorafenib for the first-line treatment of uHCC. The objective of this study was to evaluate the cost-effectiveness of lenvatinib compared with sorafenib for patients with uHCC in Japan. Methods A partitioned-survival model was developed to estimate the cost-effectiveness of lenvatinib versus sorafenib when treating uHCC patients over a lifetime horizon and considering total public healthcare expenditure. Efficacy and safety data were extracted from the REFLECT trial. Utility values were derived from the European Quality-of-Life 5-Dimension Questionnaire, conducted with patients enrolled in the REFLECT trial. Direct medical costs, such as primary drug therapy, outpatient visits, diagnostic tests, hospitalization, post-progression therapy, and adverse-event treatments, were included. Cost parameters unavailable in the clinical trial or publications were obtained based on the consolidated clinical standards from a Delphi panel of four Japanese medical experts. Results For lenvatinib versus sorafenib, the incremental cost was − 406,307 Japanese Yen (JPY), and the incremental life years and quality-adjusted life years (QALYs) were 0.27 and 0.23, respectively. Thus, lenvatinib dominated sorafenib, due to the mean incremental cost-effectiveness ratio falling in the fourth quadrant, conferring more benefit at lower costs compared with sorafenib. The probabilistic sensitivity analysis showed that 81.3% of the simulations were favorable to lenvatinib compared with sorafenib, with a payer’s willingness-to-pay-per-QALY of 5 million JPY. Conclusions Lenvatinib was cost-effective compared with sorafenib for the first-line treatment of uHCC in Japan. Electronic supplementary material The online version of this article (10.1007/s00535-019-01554-0) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
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