Abstract：
BACKGROUND: Atezolizumab (ATZ) plus bevacizumab (BVC) co-administration is one of the newest systemic interventions in advanced hepatocellular carcinoma (AHCC). This treatment approach is more costly and effective than other therapeutic interventions, significantly improving AHCC survival and health-related quality of life.
OBJECTIVE: This economic study aimed to systematically review all cost-effectiveness analyses of ATZ/BVC combination in AHCC.
METHODS: A comprehensive search in scientific databases was performed using a highly sensitive syntax to find all related economic evaluations. The target population was AHCC patients. The intervention was ATZ/BVC, which was compared with sorafenib, nivolumab, and other anticancer strategies. We included studies that reported quality-adjusted life-years (QALYs) and/or life-years, costs, and incremental cost-effectiveness ratio (ICER), and finally, the characteristics of included studies were categorized.
RESULTS: Out of 315 identified records, 12 cost-effectiveness analyses were eligible for inclusion in the systematic review. Treatment costs were significantly higher with ATZ/BVC in all studies (from 61,397 to 253,687 USD/patient compared to sorafenib and nivolumab, respectively). Incremental QALYs/patient varied from 0.35 to 0.86 compared to sintilimab/BVC and sorafenib. Although ICERs for drugs varied widely, all were united in the lack of cost-effectiveness of the ATZ/BVC. The willingness-to-pay threshold in all studies was lower than the ICER, which indicated a reluctance to pay for this treatment strategy by the health systems.
CONCLUSIONS: The ATZ/BVC combination is an expensive targeted immunotherapy in AHCC. Significant discounts in ATZ and BVC prices are essential for this novel approach to be cost-effective and extensively used.
OBJECTIVE: This economic study aimed to systematically review all cost-effectiveness analyses of ATZ/BVC combination in AHCC.
METHODS: A comprehensive search in scientific databases was performed using a highly sensitive syntax to find all related economic evaluations. The target population was AHCC patients. The intervention was ATZ/BVC, which was compared with sorafenib, nivolumab, and other anticancer strategies. We included studies that reported quality-adjusted life-years (QALYs) and/or life-years, costs, and incremental cost-effectiveness ratio (ICER), and finally, the characteristics of included studies were categorized.
RESULTS: Out of 315 identified records, 12 cost-effectiveness analyses were eligible for inclusion in the systematic review. Treatment costs were significantly higher with ATZ/BVC in all studies (from 61,397 to 253,687 USD/patient compared to sorafenib and nivolumab, respectively). Incremental QALYs/patient varied from 0.35 to 0.86 compared to sintilimab/BVC and sorafenib. Although ICERs for drugs varied widely, all were united in the lack of cost-effectiveness of the ATZ/BVC. The willingness-to-pay threshold in all studies was lower than the ICER, which indicated a reluctance to pay for this treatment strategy by the health systems.
CONCLUSIONS: The ATZ/BVC combination is an expensive targeted immunotherapy in AHCC. Significant discounts in ATZ and BVC prices are essential for this novel approach to be cost-effective and extensively used.
摘要：
背景：阿替珠单抗（ATZ）加贝伐单抗（BVC）联合给药是晚期肝细胞癌（AHCC）的最新系统性干预措施之一。这种治疗方法比其他治疗干预措施更昂贵和有效,显着提高AHCC的生存率和健康相关的生活质量。
目的：本经济学研究旨在系统评价ATZ/BVC组合在AHCC中的所有成本效益分析。
方法：使用高度敏感的语法在科学数据库中进行了全面搜索，以查找所有相关的经济评估。目标人群是AHCC患者。干预是ATZ/BVC，与索拉非尼相比，Nivolumab,和其他抗癌策略。我们纳入了报告质量调整寿命年(QALYs)和/或寿命年的研究，成本,和增量成本效益比(ICER)，最后，纳入研究的特征进行了分类.
结果：在315条确定的记录中，12项成本效益分析符合纳入系统评价的条件。在所有研究中，ATZ/BVC的治疗费用均显着较高（与索拉非尼和纳武单抗相比，从61,397美元/患者至253,687美元/患者，分别)。与sintilimab/BVC和索拉非尼相比，增加的QALY/患者从0.35到0.86不等。尽管药物的ICER差异很大，由于ATZ/BVC缺乏成本效益，所有人都团结一致。所有研究中的支付意愿阈值都低于ICER，这表明卫生系统不愿为这种治疗策略付费。
结论：ATZ/BVC联合治疗AHCC是一种昂贵的靶向免疫疗法。ATZ和BVC价格的大幅折扣对于这种新颖的方法具有成本效益并广泛使用至关重要。
目的：本经济学研究旨在系统评价ATZ/BVC组合在AHCC中的所有成本效益分析。
方法：使用高度敏感的语法在科学数据库中进行了全面搜索，以查找所有相关的经济评估。目标人群是AHCC患者。干预是ATZ/BVC，与索拉非尼相比，Nivolumab,和其他抗癌策略。我们纳入了报告质量调整寿命年(QALYs)和/或寿命年的研究，成本,和增量成本效益比(ICER)，最后，纳入研究的特征进行了分类.
结果：在315条确定的记录中，12项成本效益分析符合纳入系统评价的条件。在所有研究中，ATZ/BVC的治疗费用均显着较高（与索拉非尼和纳武单抗相比，从61,397美元/患者至253,687美元/患者，分别)。与sintilimab/BVC和索拉非尼相比，增加的QALY/患者从0.35到0.86不等。尽管药物的ICER差异很大，由于ATZ/BVC缺乏成本效益，所有人都团结一致。所有研究中的支付意愿阈值都低于ICER，这表明卫生系统不愿为这种治疗策略付费。
结论：ATZ/BVC联合治疗AHCC是一种昂贵的靶向免疫疗法。ATZ和BVC价格的大幅折扣对于这种新颖的方法具有成本效益并广泛使用至关重要。
