First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness Analysis
Background: Hepatocellular carcinoma poses a significant public health burden in China, necessitating the economic evaluation of new therapeutic strategies for policy-makers and clinicians. The international, randomized phase 3 trial CARES-310 revealed that camrelizumab plus rivoceranib provided a s...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-11-01
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| Series: | Clinical Medicine Insights: Oncology |
| Online Access: | https://doi.org/10.1177/11795549241299393 |
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| author | Guiyuan Xiang Yueyue Huang Ni Zhang Xinyu Du Yuanlin Wu Lanlan Gan Yanping Li Tingting Jiang Yao Liu |
| author_facet | Guiyuan Xiang Yueyue Huang Ni Zhang Xinyu Du Yuanlin Wu Lanlan Gan Yanping Li Tingting Jiang Yao Liu |
| author_sort | Guiyuan Xiang |
| collection | DOAJ |
| description | Background: Hepatocellular carcinoma poses a significant public health burden in China, necessitating the economic evaluation of new therapeutic strategies for policy-makers and clinicians. The international, randomized phase 3 trial CARES-310 revealed that camrelizumab plus rivoceranib provided a substantial clinical benefit in patients with advanced hepatocellular carcinoma, but the economic outcome remains unclear. This study aimed to evaluate the cost-effectiveness of camrelizumab plus rivoceranib versus sorafenib as first-line treatment for unresectable hepatocellular carcinoma (CARES-310) from the perspective of the Chinese health care system. Methods: A partitioned survival model was developed to estimate the lifetime cost and clinical outcomes of camrelizumab plus rivoceranib versus sorafenib in first-line treatment of advanced hepatocellular carcinoma. Survival data from the CARES-310 trial were used to create a hypothetical cohort of 543 patients with advanced hepatocellular carcinoma for modeling disease progression. The life-year, quality-adjusted life-year (QALY), incremental cost-effectiveness ratio (ICER) was used to measure the model’s outcome, with the willingness-to-pay threshold set at 3 times China’s gross domestic product (GDP) per capita (US$36 780). Univariate, multivariable probabilistic sensitivity analyses, and subgroup analysis were performed to assess parameter uncertainty, complemented by a scenario analysis using health utilities reported in literature. Results: The camrelizumab group yielded an additional 0.239 QALYs at an added cost of US$8340 compared with sorafenib, resulting in an ICER of US$34 897/QALY. Univariate sensitivity analysis indicated that the model results were most sensitive to the utility of progression-free survival in the camrelizumab group, sorafenib cost, and camrelizumab cost. Probabilistic sensitivity analysis revealed a 56% probability of cost-effectiveness of camrelizumab plus rivoceranib among all patients. The results of the subgroup analysis demonstrated camrelizumab plus rivoceranib was the most cost-effective in the subgroup with albumin-bilirubin grade 2. Conclusions: At a willingness-to-pay threshold of US$36 780/QALY, camrelizumab plus rivoceranib is likely to be a cost-effective option compared with sorafenib as first-line treatment for advanced hepatocellular carcinoma in China. |
| format | Article |
| id | doaj-art-25ea1a2791134508bdc3da28d0dc472e |
| institution | Kabale University |
| issn | 1179-5549 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Oncology |
| spelling | doaj-art-25ea1a2791134508bdc3da28d0dc472e2024-11-23T13:03:18ZengSAGE PublishingClinical Medicine Insights: Oncology1179-55492024-11-011810.1177/11795549241299393First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness AnalysisGuiyuan Xiang0Yueyue Huang1Ni Zhang2Xinyu Du3Yuanlin Wu4Lanlan Gan5Yanping Li6Tingting Jiang7Yao Liu8Department of Pharmacy, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Operation Management, Chongqing Health Center for Women and Children, Chongqing, ChinaDepartment of Pharmacy, Daping Hospital, Army Medical University, Chongqing, ChinaSchool of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, ChinaDepartment of Pharmacy, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Pharmacy, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Pharmacy, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Pharmacy, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Pharmacy, Daping Hospital, Army Medical University, Chongqing, ChinaBackground: Hepatocellular carcinoma poses a significant public health burden in China, necessitating the economic evaluation of new therapeutic strategies for policy-makers and clinicians. The international, randomized phase 3 trial CARES-310 revealed that camrelizumab plus rivoceranib provided a substantial clinical benefit in patients with advanced hepatocellular carcinoma, but the economic outcome remains unclear. This study aimed to evaluate the cost-effectiveness of camrelizumab plus rivoceranib versus sorafenib as first-line treatment for unresectable hepatocellular carcinoma (CARES-310) from the perspective of the Chinese health care system. Methods: A partitioned survival model was developed to estimate the lifetime cost and clinical outcomes of camrelizumab plus rivoceranib versus sorafenib in first-line treatment of advanced hepatocellular carcinoma. Survival data from the CARES-310 trial were used to create a hypothetical cohort of 543 patients with advanced hepatocellular carcinoma for modeling disease progression. The life-year, quality-adjusted life-year (QALY), incremental cost-effectiveness ratio (ICER) was used to measure the model’s outcome, with the willingness-to-pay threshold set at 3 times China’s gross domestic product (GDP) per capita (US$36 780). Univariate, multivariable probabilistic sensitivity analyses, and subgroup analysis were performed to assess parameter uncertainty, complemented by a scenario analysis using health utilities reported in literature. Results: The camrelizumab group yielded an additional 0.239 QALYs at an added cost of US$8340 compared with sorafenib, resulting in an ICER of US$34 897/QALY. Univariate sensitivity analysis indicated that the model results were most sensitive to the utility of progression-free survival in the camrelizumab group, sorafenib cost, and camrelizumab cost. Probabilistic sensitivity analysis revealed a 56% probability of cost-effectiveness of camrelizumab plus rivoceranib among all patients. The results of the subgroup analysis demonstrated camrelizumab plus rivoceranib was the most cost-effective in the subgroup with albumin-bilirubin grade 2. Conclusions: At a willingness-to-pay threshold of US$36 780/QALY, camrelizumab plus rivoceranib is likely to be a cost-effective option compared with sorafenib as first-line treatment for advanced hepatocellular carcinoma in China.https://doi.org/10.1177/11795549241299393 |
| spellingShingle | Guiyuan Xiang Yueyue Huang Ni Zhang Xinyu Du Yuanlin Wu Lanlan Gan Yanping Li Tingting Jiang Yao Liu First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness Analysis Clinical Medicine Insights: Oncology |
| title | First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness Analysis |
| title_full | First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness Analysis |
| title_fullStr | First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness Analysis |
| title_full_unstemmed | First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness Analysis |
| title_short | First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness Analysis |
| title_sort | first line camrelizumab plus rivoceranib in advanced hepatocellular carcinoma a china based cost effectiveness analysis |
| url | https://doi.org/10.1177/11795549241299393 |
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