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Cost-effectiveness analysis of atezolizumab plus bevacizumab compared with sorafenib as first-line treatment in advanced hepatocellular carcinoma in Singapore.
- Source :
-
Expert review of pharmacoeconomics & outcomes research [Expert Rev Pharmacoecon Outcomes Res] 2024 Jun; Vol. 24 (5), pp. 631-641. Date of Electronic Publication: 2024 May 22. - Publication Year :
- 2024
-
Abstract
- Objectives: This study aims to explore the cost-effectiveness of atezolizumab plus bevacizumab against sorafenib for first-line treatment of locally advanced or metastatic hepatocellular carcinoma (HCC) in Singapore.<br />Methods: A partitioned survival model was developed from a healthcare system perspective, with a 10-year lifetime horizon. Clinical inputs and utilities were obtained from the IMbrave150 trial. Healthcare resource use costs were obtained from published local sources; drug costs reflected the most recent public hospital selling prices. Outcomes included life years, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Deterministic and probabilistic sensitivity analyses were performed to assess the model's robustness.<br />Results: Atezolizumab plus bevacizumab offered an additional 1.42 life years and 1.09 QALYs, with an additional cost of S$111,847; the ICER was S$102,988/QALY. The World Health Organization considers interventions with ICERs <1 gross domestic product (GDP)/capita to be highly cost-effective. At a willingness-to-pay (WTP) threshold of S$114,165/QALY (Singapore's 2022 GDP/capita), atezolizumab plus bevacizumab is cost-effective compared with sorafenib. The ICER was most sensitive to variations in utilities, but all parameter variations had no significant impact on the model outcomes.<br />Conclusion: At a WTP threshold of Singapore's GDP/capita, atezolizumab plus bevacizumab is cost-effective compared with sorafenib.
- Subjects :
- Humans
Singapore
Drug Costs
Cost-Effectiveness Analysis
Bevacizumab administration & dosage
Bevacizumab economics
Sorafenib administration & dosage
Sorafenib economics
Cost-Benefit Analysis
Liver Neoplasms drug therapy
Liver Neoplasms economics
Carcinoma, Hepatocellular drug therapy
Carcinoma, Hepatocellular economics
Carcinoma, Hepatocellular pathology
Quality-Adjusted Life Years
Antibodies, Monoclonal, Humanized administration & dosage
Antibodies, Monoclonal, Humanized economics
Antineoplastic Combined Chemotherapy Protocols economics
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1744-8379
- Volume :
- 24
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Expert review of pharmacoeconomics & outcomes research
- Publication Type :
- Academic Journal
- Accession number :
- 38776431
- Full Text :
- https://doi.org/10.1080/14737167.2024.2319607