METHODS: A 3-state partitioned survival model was employed to assess ivosidenib\'s cost-effectiveness over a 10-year horizon with a 3% discount rate, setting the willingness-to-pay threshold at 3 times the 2022 GDP per capita. Efficacy data for Ivosidenib, mFOLFOX, and 5-FU/LV were sourced from the ClarIDHy, ABC06, and NIFTY trials, respectively. Ivosidenib\'s cost was assumed to be NT$10,402/500 mg. Primary outcomes included incremental cost-effectiveness ratios (ICERs) and net monetary benefit. Deterministic sensitivity analyses (DSA) and probabilistic sensitivity analyses (PSA) were employed to evaluate uncertainty and explore price reduction scenarios.
RESULTS: Ivosidenib exhibited ICERs of NT$6,268,528 and NT$5,670,555 compared with mFOLFOX and 5-FU/LV, respectively, both exceeding the established threshold. PSA revealed that ivosidenib was unlikely to be cost-effective, except when it was reduced to NT$4,161 and NT$5,201/500 mg when compared with mFOLFOX and 5-FU/LV, respectively. DSA underscored the significant influence of ivosidenib\'s cost and utility values on estimate uncertainty.
CONCLUSIONS: At NT$10,402/500 mg, ivosidenib was not cost-effective for IDH1-mutant ICC patients compared with mFOLFOX or 5-FU/LV, indicating that a 50-60% price reduction is necessary for ivosidenib to be cost-effective in this patient group.
方法:采用3状态分区生存模型,以3%的折现率评估ivosidenib在10年内的成本效益。将支付意愿门槛设定为2022年人均GDP的3倍。Ivosidenib的疗效数据,mFOLFOX,5-FU/LV来自ClaridHy,ABC06和NIFTY试验,分别。Ivosidenib的成本假定为新台币10,402/500毫克。主要结果包括增量成本效益比(ICER)和净货币收益。采用确定性敏感性分析(DSA)和概率敏感性分析(PSA)来评估不确定性并探索降价方案。
结果:Ivosidenib的ICER分别为新台币6,268,528和新台币5,670,555,而mFOLFOX和5-FU/LV,分别,都超过了既定的门槛。PSA透露,ivosidenib不太可能具有成本效益,除了与mFOLFOX和5-FU/LV相比,它减少到新台币4,161元和新台币5,201/500毫克,分别。DSA强调了ivosidenib的成本和效用值对估计不确定性的重大影响。
结论:以新台币10,402元/500毫克,与mFOLFOX或5-FU/LV相比,Ivosidenib对IDH1突变ICC患者的成本效益不佳,这表明,在该患者组中,要使ivosidenib具有成本效益,必须将价格降低50-60%。