Cost-utility analysis of bevacizumab combined with erlotinib in the first-line treatment of advanced EGFR mutant non-squamous NSCLC
- VernacularTitle:贝伐珠单抗联合厄洛替尼一线治疗晚期EGFR突变型非鳞状NSCLC的成本-效用分析
- Author:
Wenxiang JU
1
;
Yingying ZHAO
1
;
Luolan LU
1
;
Xiaohan ZHANG
1
;
Aizong SHEN
1
Author Information
1. College of Pharmacy，Anhui University of Chinese Medicine，Hefei 230012，China;Anhui Province Medicines Clinical Comprehensive Evaluation Technology Center，Hefei 230001，China;Anhui Provincial Key Laboratory of Precision Pharmaceutical Preparation and Clinical Pharmacy，Hefei 230001，China;Anhui Provincial Key Laboratory of Philosophy and Social Sciences for Public Health and Social Governance，Hefei 230032，China;Discipline Key Laboratory for Key Technology Research and Clinical Application of Mass Spectrometry Jointly Constructed by Anhui Province，Hefei 230088，China
- Publication Type:Journal Article
- Keywords:
bevacizumab;
erlotinib;
dynamic Markov model;
cost-utility analysis;
epithelial growth factor receptor;
non-
- From:
China Pharmacy
2024;35(11):1357-1362
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the cost-effectiveness of bevacizumab combined with erlotinib in the first-line treatment of advanced EGFR mutant non-squamous non-small cell lung cancer （NSCLC） from the perspective of China’s health system. METHODS A dynamic Markov model was established based on BEVERLY study data， with a cycle of 3 weeks， a research deadline until 99% of patients die， and an annual discount rate of 5%. The model outputs were total cost， quality-adjusted life year （QALY）， and incremental cost-effectiveness ratio （ICER）. Taking 3 times China’s per capita gross domestic product （GDP） in 2023 as the willingness-to-pay （WTP） threshold， the cost-utility analysis was used to evaluate the cost-effectiveness of bevacizumab combined with erlotinib （observation group） versus erlotinib alone （control group） in the first-line treatment of advanced EGFR mutant non-squamous NSCLC， and the single factor sensitivity analysis and probability sensitivity analysis were used to verify the robustness of the basic analysis results. RESULTS The results of the basic analysis showed that compared with the erlotinib therapy plan， ICER of bevacizumab combined with erlotinib was 1 452 243.01 yuan/QALY， which was more than 3 times China’s per capita GDP in 2023 （268 074 yuan/QALY） as the WTP threshold， indicating that bevacizumab combined with erlotinib was not cost-effective. The results of single factor sensitivity analysis showed that the cost of bevacizumab， the utility value of progression-free survival and progressed disease status had a great influence on the results. The results of probability sensitivity analysis showed that when the WTP threshold was 1 740 000 yuan/QALY， the probability of cost-effective of bevacizumab combined with erlotinib plan was 50%. CONCLUSIONS Compared with erlotinib alone， bevacizumab combined with erlotinib is not cost-effective in the first-line treatment of advanced EGFR mutant non-squamous NSCLC， when using 3 times China’s per capita GDP in 2023 as the WTP threshold.
