Economic evaluation of NALIRIFOX regimen for first-line treatment of metastatic pancreatic cancer
- VernacularTitle:NALIRIFOX方案一线治疗转移性胰腺癌的经济学评价
- Author:
Han GAO
1
;
Dongxue HU
2
;
Caifeng JIA
3
;
Mingxia WANG
3
Author Information
1. Dept. of Clinical Pharmacology，the Fourth Hospital of Hebei Medical University，Shijiazhuang 050011，China;Dept. of Pharmacy，the Fourth Hospital of Hebei Medical University，Shijiazhuang 050011，China
2. Dept. of Pharmacy，the Fourth Hospital of Hebei Medical University，Shijiazhuang 050011，China
3. Dept. of Clinical Pharmacology，the Fourth Hospital of Hebei Medical University，Shijiazhuang 050011，China
- Publication Type:Journal Article
- Keywords:
Irinotecan liposome;
NALIRIFOX regimen
- From:
China Pharmacy
2025;36(21):2681-2686
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE From the perspective of China’s health system， to evaluate the economic efficiency of Irinotecan liposome+fluorouracil+calcium folinate+oxaliplatin（NALIRIFOX regimen） versus paclitaxel （albumin-bound） combined with gemcitabine （AG regimen） in the first-line treatment of metastatic pancreatic cancer. METHODS A dynamic Markov model was constructed based on the data from the NAPOLI 3 clinical trial， with a cycle period of 28 days and a simulation time limit of 5 years. Incremental cost-effectiveness ratio （ICER） and quality-adjusted life year （QALY） were used as the model output indicators. The willingness-to-pay （WTP） threshold was set at three times China’s 2024 per capita gross domestic product （GDP）， and a discount rate of 5% was adopted. A cost-utility analysis was conducted to analyze the economic efficiency of the NALIRIFOX regimen compared to the AG regimen. Univariate sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the robustness of the model results， and scenario analysis was conducted by reducing the cost of irinotecan liposome by 60% and 70%. RESULTS The base-case analysis showed that the ICER of the NALIRIFOX regimen was 854 669.96 yuan/QALY compared to the AG regimen， which was greater than the WTP threshold （287 247 yuan/QALY）， indicating that the NALIRIFOX regimen was not economically efficient. The univariate sensitivity analysis results indicated that the discount rate， the cost of irinotecan liposome， the utility value of the progression-free survival state， and the utility value of the disease progression state had a significant impact on the ICER. The probabilistic sensitivity analysis results showed that under the WTP threshold of this study， the NALIRIFOX regimen was not economically efficient compared with the AG regimen. The scenario analysis results indicated that when the price was reduced by 70%， the probability of the NALIRIFOX regimen being economically efficient compared with the AG regimen was 9.60%. CONCLUSIONS From the perspective of China’s health system， when the WTP threshold is set at three times China’s 2024 per capita GDP， the NALIRIFOX regimen is not economically efficient in the first-line treatment of metastatic pancreatic cancer， compared with the AG regimen.
