Cost-utility analysis of switching to gemcitabine maintenance therapy for malignant mesothelioma patients after first-line chemotherapy
- VernacularTitle:恶性间皮瘤患者一线化疗后转换吉西他滨维持治疗的成本-效用分析
- Author:
Jun YOU
1
;
Wenxiu XIN
1
;
Chaoneng HE
1
;
Qilu FANG
1
Author Information
1. Dept. of Pharmacy，Zhejiang Cancer Hospital，Hangzhou 310022，China
- Publication Type:Journal Article
- Keywords:
malignant mesothelioma;
maintenance therapy;
gemcitabine;
cost-utility analysis;
pharmacoeconomics;
best
- From:
China Pharmacy
2025;36(7):843-847
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the cost-utility of switching to gemcitabine maintenance therapy for patients with unresectable malignant mesothelioma after first-line chemotherapy from the perspective of China’s healthcare system. METHODS A partitioned survival model was constructed based on data from the NVALT19 trial， with a cycle length of 21 days， a time horizon of 10 years， and a discount rate of 5%. Key model outputs included total costs， quality-adjusted life year （QALY）， incremental costs， and incremental cost-effectiveness ratio （ICER）， etc. Cost-utility analysis was conducted to evaluate the cost- effectiveness of gemcitabine maintenance therapy （gemcitabine group） plan versus best supportive care （supportive care group） plan for the patients with unresectable malignant mesothelioma after first-line chemotherapy. Sensitivity analyses were performed. RESULTS Compared with the supportive care group plan， the gemcitabine group plan had an ICER of 54 860.50 yuan/QALY， which was significantly lower than the willingness-to-pay （WTP） threshold （3 times China’s 2023 per capita gross domestic product， 268 077 yuan/QALY）， indicating that gemcitabine group plan was cost-effective. One-way sensitivity analysis revealed that end-of-life care costs and adverse event management costs in the gemcitabine group had the greatest impact on ICER. Probabilistic sensitivity analysis showed gemcitabine group plan was 100% cost-effective when WTP exceeded 270 000 yuan/QALY. CONCLUSIONS From the perspective of China’s healthcare system， switching to gemcitabine maintenance therapy after first-line chemotherapy is cost-effective for unresectable malignant mesothelioma.
