METHODS: A partitioned survival model was developed to assess the cost-effectiveness of rezvilutamide combined with ADT. Clinical data were obtained from the CHART trial. Costs and utility values were obtained from local estimate and published literature. Only direct medical costs were included in the model.
METHODS: Rezvilutamide was administered at 240 mg daily or bicalutamide at 50 mg daily until progression.
METHODS: The main outputs of the model included costs and quality-adjusted life years (QALYs), which were used to determine the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analysis (PSA) were used to explore model uncertainties.
RESULTS: The rezvilutamide group showed an expected gain of 2.28 QALYs and an incremental cost of US$60 758.82 compared with the bicalutamide group. The ICER for rezvilutamide group versus bicalutamide group was US$26 656.94 per QALY. The variables with the greatest impact on the model results were the utility for progression-free survival state and the price of rezvilutamide. PSA revealed that rezvilutamide group had 100% probability of being cost-effective at a willingness-to-pay threshold of US$35707.5 per QALY.
CONCLUSIONS: Rezvilutamide in combination with ADT is more cost-effective compared with bicalutamide plus ADT as the first-line treatment of mHSPC from the perspective of the Chinese healthcare system.
方法:建立分区生存模型以评估瑞维鲁胺联合ADT的成本-效果。临床数据来自CHART试验。成本和效用值是从当地估计和出版的文献中获得的。模型中仅包括直接医疗费用。
方法:Rezvilutamide每天240mg或比卡鲁胺每天50mg直至进展。
方法:模型的主要输出包括成本和质量调整寿命年(QALYs),用于确定增量成本效益比(ICER)。使用单向和概率敏感性分析(PSA)来探索模型的不确定性。
结果:与比卡鲁胺组相比,瑞兹维鲁他胺组显示出2.28QALYs的预期收益和60758.82美元的增量成本。瑞维鲁他胺组与比卡鲁胺组的ICER为每QALY26656.94美元。对模型结果影响最大的变量是无进展生存状态的效用和瑞维鲁胺的价格。PSA显示,rezvilutamide组在每QALY35707.5美元的支付意愿阈值下具有100%的成本效益。
结论:从中国医疗保健系统的角度来看,与比卡鲁胺联合ADT作为mHSPC的一线治疗相比,Rezvilutamide联合ADT更具成本效益。