Abstract：
BACKGROUND: This study sought to investigate the affordable price of sotorasib among patients with previously treated advanced KRASG12C-mutant non-small cell lung cancer (NSCLC) through a cost-effectiveness analysis from the perspectives of both the Chinese healthcare system and the patients.
METHODS: We developed a Markov model spanning a 20-year time horizon with a cycle length of 21 days. Our data were derived from the CodeBreaK 200 clinical trial, supplemented with published literature, publicly available national databases, and local hospitals. The primary outcomes were the affordable prices of sotorasib which would result in the incremental cost-effectiveness ratios (ICERs) of sotorasib relative to docetaxel below the preset willing-to-pay (WTP) threshold. Sensitivity analyses were performed to evaluate the model\'s robustness.
RESULTS: At the national level, from the perspective of the Chinese healthcare system and patients, the price of sotorasib should be lower than US$0.04673 and $0.03231, respectively, to make it affordable, which is equivalent to $1346 and $931 per box (120 mg × 240 pieces). At the provincial level, the price ceiling of sotorasib/mg fluctuated between $0.04084 to $0.08061 from the Chinese healthcare system\'s perspective and between $0.02642 to $0.06620 from the patients\' perspective. Probabilistic sensitivity analyses revealed that, as the price of sotorasib decreased, its likelihood of being cost-effective increased.
CONCLUSIONS: Sotorasib might be a cost-effective therapy in China. The pharmaco-economic evidence generated from this study has significant implications not only for guiding the drug pricing of the upcoming sotorasib but also for determining the reimbursement ratio for its potential inclusion in the National Reimbursement Drugs List in the future.
METHODS: We developed a Markov model spanning a 20-year time horizon with a cycle length of 21 days. Our data were derived from the CodeBreaK 200 clinical trial, supplemented with published literature, publicly available national databases, and local hospitals. The primary outcomes were the affordable prices of sotorasib which would result in the incremental cost-effectiveness ratios (ICERs) of sotorasib relative to docetaxel below the preset willing-to-pay (WTP) threshold. Sensitivity analyses were performed to evaluate the model\'s robustness.
RESULTS: At the national level, from the perspective of the Chinese healthcare system and patients, the price of sotorasib should be lower than US$0.04673 and $0.03231, respectively, to make it affordable, which is equivalent to $1346 and $931 per box (120 mg × 240 pieces). At the provincial level, the price ceiling of sotorasib/mg fluctuated between $0.04084 to $0.08061 from the Chinese healthcare system\'s perspective and between $0.02642 to $0.06620 from the patients\' perspective. Probabilistic sensitivity analyses revealed that, as the price of sotorasib decreased, its likelihood of being cost-effective increased.
CONCLUSIONS: Sotorasib might be a cost-effective therapy in China. The pharmaco-economic evidence generated from this study has significant implications not only for guiding the drug pricing of the upcoming sotorasib but also for determining the reimbursement ratio for its potential inclusion in the National Reimbursement Drugs List in the future.
摘要：
背景：本研究旨在从中国医疗系统和患者的角度，通过成本效益分析，调查索托拉西在先前治疗过的晚期KRASG12C突变非小细胞肺癌（NSCLC）患者中的可负担得起的价格。
方法：我们开发了一个马尔可夫模型，其时间跨度为20年，周期长度为21天。我们的数据来自CodeBreaK200临床试验，辅以已出版的文献，公开的国家数据库，当地医院。主要结果是sotorasib的负担得起的价格，这将导致sotorasib相对于多西他赛的增量成本效益比（ICER）低于预设的愿意支付（WTP）阈值。进行敏感性分析以评估模型的稳健性。
结果：在国家一级，从中国医疗体系和患者的角度来看，索托拉西的价格应分别低于0.04673美元和0.03231美元，为了让它负担得起，相当于每盒1346美元和931美元(120毫克×240件)。在省一级,从中国医疗系统的角度来看，索托拉西/毫克的价格上限在0.04084美元至0.08061美元之间波动，从患者的角度来看，价格上限在0.02642美元至0.06620美元之间波动。概率敏感性分析显示，随着索托拉西布的价格下降，其具有成本效益的可能性增加。
结论：索托拉西在中国可能是一种具有成本效益的治疗方法。这项研究产生的药物经济学证据不仅对指导即将到来的索托拉西布的药物定价具有重要意义，而且对确定未来可能纳入国家报销药物清单的报销比例也具有重要意义。
方法：我们开发了一个马尔可夫模型，其时间跨度为20年，周期长度为21天。我们的数据来自CodeBreaK200临床试验，辅以已出版的文献，公开的国家数据库，当地医院。主要结果是sotorasib的负担得起的价格，这将导致sotorasib相对于多西他赛的增量成本效益比（ICER）低于预设的愿意支付（WTP）阈值。进行敏感性分析以评估模型的稳健性。
结果：在国家一级，从中国医疗体系和患者的角度来看，索托拉西的价格应分别低于0.04673美元和0.03231美元，为了让它负担得起，相当于每盒1346美元和931美元(120毫克×240件)。在省一级,从中国医疗系统的角度来看，索托拉西/毫克的价格上限在0.04084美元至0.08061美元之间波动，从患者的角度来看，价格上限在0.02642美元至0.06620美元之间波动。概率敏感性分析显示，随着索托拉西布的价格下降，其具有成本效益的可能性增加。
结论：索托拉西在中国可能是一种具有成本效益的治疗方法。这项研究产生的药物经济学证据不仅对指导即将到来的索托拉西布的药物定价具有重要意义，而且对确定未来可能纳入国家报销药物清单的报销比例也具有重要意义。
