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cost-utility analysis of Nivolumab plus Chemotherapy in the First-Line Treatment of Upper Gastrointestinal Adenocarcinoma

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Pharmacology & Pharmacy 2022年第6期13卷 212-224页

作者： Xin Fan Yongfa Chen School of International Pharmaceutical Business of China Pharmaceutical University Nanjing China

Objective: To evaluate the cost-utility of nivolumab plus chemotherapy compared with chemotherapy alone as the first-line treatment for advanced gastric, gastro-oesophageal junction, and esophageal adenocarcinoma in China. Methods: Based on CheckMate649, a partitioned survival model was carried out with a circulation cycle of 6 weeks to simulate the patient’s lifetime. Sensitivity analysis were adopted to verify the robustness of the results. Results: The results of the base-case analysis showed that both the total cost and utility of the nivolumab group were higher, and the ICUR value was CNY 267498.67/QALY, more than 3 times the GDP per capita of China in 2020. The results of deterministic sensitivity analysis indicated that the three most influential factors were the utility value of PFS state, the cost of nivolumab and the discount rate. The results of probabilistic sensitivity analysis were consistent with those of base-case analysis, proving that the results were robust. The scenario analysis illustrated that economical price of nivolumab was CNY 3652.71. Conclusions: Under the willing-to-pay threshold of three times the GDP per capita of China in 2020, compared with chemotherapy alone, nivolumab plus chemotherapy is not a cost-effective option in China.

关键词： Nivolumab Gastric Adenocarcinoma Gastro-Oesophageal Junction Adenocarcinoma Esophageal Adenocarcinoma Partitioned Survival Model cost-utility analysis

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cost-utility analysis of dapagliflozin versus saxagliptin treatment as monotherapy or combination therapy as add-on to metformin for treating type 2 diabetes mellitus

Cost-utility analysis of dapagliflozin versus saxagliptin tr...

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2021第26届广东省药师周大会

作者： HU Shanshan DENG Xun MA Yanjiao LI Zhilei WANG Yuhang WANG Yong Department of Pharmacy Zhujiang Hospital Southern Medical University

OBJECTIVE: To assess the long-term cost-effectiveness of dapagliflozin(DAPA) and saxagliptin(SAXA) separately or together in patients with type 2 diabetes mellitus(T2DM) inadequately controlled by metformin(MET). METHODS: Five head-to-head randomized controlled trials of the efficacy of DAPA and SAXA in T2DM patients were found by searching PubMed, Embase and Cochrane from inception to October 2019. The lifetime disease progression and long-term effectiveness of therapy in patients were projected by the United Kingdom Prospective Diabetes Study Outcome Model 2(UKPDS OM2) in three T2DM therapeutic groups: DAPA+SAXA, DAPA and SAXA. Each group used DAPA and/or SAXA as an add-on therapy to MET. The study took the perspective of Chinese healthcare service providers. Univariate, scenario and probabilistic sensitivity analyses were performed. RESULTS: The quality-adjusted life years(QALYs) value of the DAPA+SAXA, SAXA and DAPA groups were 11.28, 11.26 and 11.45 years, respectively. The total costs were US$27954.84,US$23254.46 and US$25608.49, respectively. DAPA was dominant over DAPA+SAXA. The DAPA+SAXA group presented an estimated QALY gain of 0.02 and a total cost increase of US$4700.39 over the SAXA group, with an incremental cost of US$217530.10 per QALY. Compared with the SAXA group, the DAPA group had a QALY gain of 0.19 years and a total cost increase of US$2354.04, for an incremental cost of US$12191.97 per QALY. The pharmacoeconomic results were robust to univariate, scenario and probabilistic sensitivity analyses. CONCLUSIONS: Compared with DAPA+SAXA or SAXA, DAPA appears to be a cost-effective therapy as add-on to MET for Chinese patients whose T2DM is insufficiently controlled by MET.

关键词： cost-utility analysis dapagliflozin saxagliptin T2DM UKPDS Outcome Model

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Value within otolaryngology:Assessment of the cost-utility analysis literature

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第1期2卷 -页

作者： Krupa R. Patel David J. Phillips Jason M. Leibowitz Theresa Scognamiglio Victoria E. Banuchi William I. Kuhel David I. Kutler Marc A. Cohen Weill Cornell Medical College New York NY 10065 USA Department of 0tolaryngology-Head and Neck Surgery New York Presbyterian Hospital/Weill Cornell Medical Center New York NY 10065 USA Department of 0tolaryngology-Head and Neck Surgery University of Miami Miami FL 33136 USA Department of Pathology&Laboratory Medicine New York Presbyterian Hospital/Weill Cornell Medical Center New York NY 10065 USA

Objective:To assess the characteristics and quality of cost utility analyses (CUA) related to otolaryngology within the CEA registry and to summarize their collective results. Methods:All cost-utility analyses published between 1976 and 2011 contained in the cost-Effectiveness analysis Registry (CEA Registry) were evaluated. Topics that fall within the care of an otolaryngologist were included in the review regardless of the presence of an otolaryn-gologist author. Potential associations between various study characteristics and CEA registry quality scores were evaluated using the Pearson product moment correlation coefficient. Results:Sixty-one of 2913 (2.1%) total CUA publications screened were related to otolaryn-gology. Eighteen of 61 (29.5%) publications included an otolaryngologist as an author. Fourteen studies agreed on the cost effectiveness of at least unilateral cochlear implantation and six of seven (85.7%) studies demonstrated the cost effectiveness of continuous positive airway pres-sure (CPAP) for obstructive sleep apnea (OSA). Forty-six percent (28 of 61) of all manuscripts were published between 2008 and 2011. A more recent publication year was associated with a higher CEA registry quality score while the presence of an otolaryngologist author and journal impact factor had no significant correlation with the quality of the CUA. Conclusion:Based on current evidence in the CEA registry, unilateral cochlear implantation for hearing loss and CPAP for OSA are both cost-effective therapeutic interventions. Although CUAs in otolaryngology have increased in quantity and improved in quality in more recent years, there is a relative lack of CUAs in otolaryngology in comparison to other subspecialties. Copyright a 2016 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-SA license (http://***/licenses/by-nc-sa/4.0/).

关键词： cost-utility analysis

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Exploring the Appropriate Price of Semaglutide for T2D Patients Based on cost-utility analysis in China

Exploring the Appropriate Price of Semaglutide for T2D Patie...

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2022第27届广东省药师周大会

作者： Shanshan Hu Xiaorong Su Xun Deng Guorong Fan Yong Wang Department of Pharmacy Zhujiang HospitalSouthern Medical University Department of Clinical Pharmacy Shanghai General HospitalShanghai Jiao Tong University School of Medicine Laboratory of Research of New Chinese Medicine Zhujiang HospitalSouthern Medical University

Introduction Once-weekly(OW) semaglutide is the first and only oral version of glucagon-like peptide-1(GLP-1) analogue approved by FDA for the treatment of type 2 diabetes(T2 D).This research was designed to explore the appropriate price of semaglutide for T2 D patients based on cost-utility analysis in *** The baseline patient cohorts of OW semaglutide and OD empagliflozin were sourced from a patient-level meta-analysis integrating SUSTAIN 2,SUSTAIN 3,SUSTAIN 8 and PIONEER *** long-term health and economic outcomes were simulated using the United Kingdom Prospective Diabetes Study Outcome Model 2(UKPDS OM2) from the Chinese healthcare provider’s *** appropriate price of semaglutide were explored by binary ***-way sensitivity analyses(one-way SA),probabilistic sensitivity analyses(PSA) and scenario analyses were applied to solve the *** At the assumption of the annual cost of semaglutide equaling to that of OD empagliflozin,OW semaglutide was superior to OD empagliflozin as its higher quality adjusted life years(QALY) and lower total *** binary search,the incremental cost-utility ratio(ICUR) of OW semaglutide versus OD empagliflozin was approximate to 3λwith the annual cost of semaglutide of $1007.18 and approximate to λwith the annual cost of semaglutide of $708.11,***,the ICUR of OW semaglutide versus OD empagliflozin was approximate to 3λandλwith the annual cost of semaglutide of $877.43 and $667.04,respectively,adjusted by one-way *** last,the cost-utility results with the annual cost of semaglutide of $877.43 and $667.04 were robust to PSA and scenario *** In conclusion,the annual cost of semaglutide appears to be appropriate between $667.04 and $877.43 for T2 D patient in China.

关键词： cost-utility analysis Type 2 diabetes Semaglutide Empagliflozin Price exploring

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cost-effectiveness analysis of tele-retinopathy of prematurity screening in Iran

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International Journal of Ophthalmology(English edition) 2021年第4期14卷 560-566页

作者： Seyed-Farzad Mohammadi Ameneh Rahban Sahel Darabeigi Nastaran Salimi Afsar Farahani Alireza Lashay Cyrus Alinia Translational Ophthalmology Research Center Farabi Eye HospitalTehran University of Medical SciencesTehran ***Iran Department of Health Management and Economics School of Public HealthUrmia University of Medical SciencesUrmia 571478334Iran

AIM:To conduct a cost-utility analysis of the teleretinopathy of prematurity(ROP)screening program against no ***:A decision tree model was developed to identify and treat the infants with threshold ROP through the tele-screening system compared with no screening program from the societal *** used the quality adjusted life years(QALY)index to measure the scenarios’effectiveness,which was discounted for the future years by *** hundred twenty-six randomly selected newborns with ROP required treatment were investigated to extract the treatment *** considered the direct medical and non-medical costs in cost calculations analysed by the bottom-up *** figures of the model’s inputs were calculated using the Monte Carlo simulation that generated 1000 random iteration of the data,and a one-way sensitivity analysis was performed on the model to cope with the potential ***:The total and per capita needed the budget to establish a tele-ROP screening system were estimated at over 1.5 million and 35.13 USD,*** total cost of identifying and treating an ROP case in tele-screening and no screening strategies were obtained as 108.72 and 63.52 USD,respectively,and their lifetime discounted QALY gained were calculated as 15.39 and 15.11,***,incremental cost-effectiveness ratio(ICER)of tele-screening strategy against the competitive strategy was achieved as 161.43 ***:Tele-ROP screening program is one of the most cost-effective interventions in the Iranian health system and has a high priority to receive a budget for implementation.

关键词： cost-utility analysis incremental cost-effectiveness ratio quality adjusted life years tele-retinopathy of prematurity

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