非洛木单抗联合贝伐珠单抗生物类似药SCT510作为晚期肝细胞癌一线治疗的成本效果分析。
完整摘要 · 中文译文
背景：III期试验NCT04560894显示，finotonlimab联合贝伐珠单抗生物类似药SCT510（FIN-BEV）在晚期肝细胞癌（HCC）中较索拉非尼改善了生存。然而，FIN-BEV相对于索拉非尼的成本效益仍不确定。本研究从中国医疗体系角度评估FIN-BEV作为晚期HCC一线治疗相比索拉非尼的成本效益。 方法：利用NCT04560894数据，在TreeAge Pro 2022中构建了包含三种健康状态的分区生存模型。药物成本根据全国中标价格计算，其他成本和效用值取自已发表的中国文献。进行敏感性分析以评估模型的稳健性。 结果：FIN-BEV产生2.43个质量调整生命年（QALY），成本为66,740.79美元；索拉非尼为1.63个QALY，成本为14,241.13美元。增量成本效果比为65,717.80美元/QALY，超过27,906美元/QALY的意愿支付阈值。FIN-BEV作为晚期HCC一线治疗具有成本效益的概率为0.2%。影响模型结果的关键因素包括无进展生存期的效用值、SCT510的成本、体重、疾病进展的效用值以及finotonlimab的成本。 结论：从中国医疗体系的角度来看，与索拉非尼相比，FIN-BEV作为晚期HCC的一线治疗不具有成本效益。
完整摘要 · 英文原文
BACKGROUND: Phase III trial NCT04560894 showed finotonlimab plus bevacizumab biosimilar SCT510 (FIN-BEV) improved survival over sorafenib in advanced hepatocellular carcinoma (HCC). However, the cost-effectiveness of FIN-BEV relative to sorafenib remains uncertain. This study evaluates the cost-effectiveness of FIN-BEV as a first-line treatment for advanced HCC from the perspective of the Chinese healthcare system, compared to sorafenib. METHODS: A partitioned survival model with three health states was built in TreeAge Pro 2022 using NCT04560894 data. Drug costs were calculated based on national bid-winning prices, while other costs and utility values were obtained from published Chinese literature. Sensitivity analyses were conducted to assess the robustness of the model. RESULTS: FIN-BEV yielded 2.43 QALYs at $66,740.79 versus sorafenib's 1.63 QALYs at $14,241.13. The incremental cost-effectiveness ratio was $65,717.80/QALY, exceeding the willingness-to-pay threshold of $27,906/QALY. The probability of FIN-BEV being cost-effective as a first-line treatment for advanced HCC was 0.2%. Key factors influencing the model results included the utility value of progression-free survival, the cost of SCT510, body weight, the utility value of progressive disease, and the cost of finotonlimab. CONCLUSION: From the perspective of the Chinese healthcare system, FIN-BEV does not represent a cost-effective first-line treatment for advanced HCC when compared to sorafenib.