Cost-effectiveness of maintenance niraparib with an individualized starting dosage in patients with platinum-sensitive recurrent ovarian cancer in China

被引:0
|
作者
Shi, Yin [1 ,2 ,3 ]
Xiao, Di [1 ,2 ,3 ]
Li, Shuishi [2 ,4 ]
Liu, Shao [1 ,2 ,3 ]
Zhang, Yu [5 ,6 ]
机构
[1] Cent South Univ, Xiangya Hosp, Dept Pharm, Changsha, Peoples R China
[2] Cent South Univ, Xiangya Hosp, Natl Clin Res Ctr Geriatr Disorders, Changsha, Peoples R China
[3] Hunan Inst Pharm Practice & Clin Res, Changsha, Peoples R China
[4] Cent South Univ, Xiangya Hosp, Dept Gen Surg, Changsha, Peoples R China
[5] Cent South Univ, Xiangya Hosp, Dept Gynecol, Changsha, Peoples R China
[6] Gynecol Oncol Res & Engn Ctr Hunan Prov, Changsha, Peoples R China
基金
中国国家自然科学基金;
关键词
niraparib; routine surveillance; ovarian cancer; maintenance therapy; cost-effectiveness; THERAPY;
D O I
10.3389/fphar.2023.1198585
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Objective: Niraparib improved survival in platinum-sensitive recurrent ovarian cancer (PSROC) patients versus routine surveillance, accompanied by increased costs. Based on the NORA trial, we evaluated for the first time the cost-effectiveness of maintenance niraparib with individualized starting dosage (ISD) in China.Methods: A Markov model was developed to simulate the costs and health outcomes of each strategy. The total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were measured. One-way and probabilistic sensitivity analysis were performed to estimate model robustness. Scenario analyses were also conducted.Results: Compared to routine surveillance, niraparib additionally increased QALYs by 0.59 and 0.30 in populations with and without germline BRCA (gBRCA) mutations, with incremental costs of $10,860.79 and $12,098.54, respectively. The ICERs of niraparib over routine surveillance were $18,653.67/QALY and $39,212.99/QALY. At a willingness-to-pay (WTP) threshold of $37,488/QALY, the ISD enhanced the likelihood of cost-effectiveness from 9.35% to 30.73% in the gBRCA-mutated group and from 0.77% to 11.74% in the non-gBRCA mutated population. The probability of niraparib being cost-effective in the region with the highest per capita Gross Domestic Product (GDP) in China was 74.23% and 76.10% in the gBRCA-mutated and non-gBRCA mutated population, respectively. Niraparib was 100% cost-effective for National Basic Medical Insurance beneficiaries under the above WTP thresholds.Conclusion: Compared to routine surveillance, the ISD of niraparib for maintenance treatment of PSROC is cost-effective in the gBRCA-mutated population and more effective but costly in the non-gBRCA mutated patients. The optimized niraparib price, economic status, and health insurance coverage may benefit the economic outcome.
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页数:9
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