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Erschienen in:
12.11.2019 | Head and Neck
Cost-effectiveness analysis of gemcitabine plus cisplatin versus fluorouracil plus cisplatin in the first-line setting for Chinese patients with metastatic nasopharyngeal carcinoma
Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 2/2020
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Purpose
A randomized phase III trial demonstrated that gemcitabine plus cisplatin (GP) prolonged progression-free survival and overall survival compared with fluorouracil plus cisplatin (FP) as first-line chemotherapy in patients with metastatic nasopharyngeal carcinoma (NPC). The cost-effectiveness analysis was designed to identify the economic option for metastatic NPC from a Chinese societal perspective.
Methods
We established a Markov model that involved three health states representing the stages of disease to simulate therapy. Survival data of clinical outcomes were derived from the trial and adjusted to quality-adjusted life years (QALYs). Transition probabilities and health utilities were obtained from the clinical trial and published literatures. The cost-effective strategy was estimated for these treatments using a willing-to-pay (WTP) threshold. A one-way sensitivity analysis was conducted to study the influences of parameters.
Results
GP treatment group produced a gain of 0.37 QALYs with an incremental cost of $2520.80, yielding an incremental cost-effectiveness ratio (ICER) of $6812.97 per QALY, compared with FP treatment ($15,530.96 versus $13,010.16). The ICER was lower than the accepted WTP threshold, which was 3 times gross domestic product per capita of China ($25,749 per QALY).
Conclusion
GP regimen is more cost-effective compared with FP regimen as the first-line treatment for Chinese patients with metastatic NPC.