Background
Method
Patient population
Model structure
Transition probabilities
Parameter | Base-case value (range) | Distribution | Reference |
---|---|---|---|
Transition Probabilities | |||
Imatinib | |||
non-CR after induction therapy | 1 | Beta | Cao 2021 [11] |
non-CR after intensive chemotherapy | 0.5 | Beta | Cao 2021 [11] |
Relapse in maintenance therapy | 0.1000 (0.0415, 0.1729) | Beta | Shen 2020 [9] |
Death of CR patients in maintenance therapy | 0.0879 (0.0364, 0.1365) | Beta | Shen 2020 [9] |
Dasatinib | |||
non-CR after induction therapy | 0.833 | Beta | Cao 2021 [11] |
CR of CR patients in intensive chemotherapy | 1 | Beta | Cao 2021 [11] |
CR of non-CR patients in intensive chemotherapy | 0.875 | Beta | Cao 2021 [11] |
Relapse in maintenance therapy | 0.0537 (0.0107, 0.1035) | Beta | Shen 2020 [9] |
Death of CR patients in maintenance therapy | 0.0304 (0.0099, 0.0504) | Beta | Shen 2020 [9] |
Death of non-CR patients in maintenance therapy | 0.6 (0.54, 0.66) | Beta | Experts' opinions |
Transplantation | |||
Transplantation in non-CR patients | 0.1 (0.09, 0.11) | Beta | Experts' opinions |
Success in transplantation | 0.4 (0.3, 0.5) | Beta | Experts' opinions |
Relapse after transplantation | 0.0582 (0.0354, 0.0806) | Beta | Lin 2019 [13] |
Death in CR patients after transplantation | 0.23 (0.21, 0.25) | Beta | Lin 2019 [13] |
Death in non-CR/ relapse patients after transplantation | 0.57 (0.49, 0.64) | Beta | Lin 2019 [13] |
Costs, CNY, per year | |||
Imatinib | |||
Drug | 104,857.2 (83,885.76, 125,828.64) | Gamma | Expense list |
Other costs in induction therapy | 71,019.18 (10,168.61, 170,406.88) | Gamma | Expense list |
Other costs in intensive chemotherapy | 266,871.23 (120,615.16, 398,733.09) | Gamma | Expense list |
Dasatinib | |||
Drug | 51,100 (40,880, 61,320) | Gamma | Expense list |
Other costs in induction therapy | 91,338.95 (26,639.48, 176,128.92) | Gamma | Expense list |
Other costs in intensive chemotherapy | 208,152.13 (141,714.97, 274,986.24) | Gamma | Expense list |
Other costs for maintenance in CR state | 57,500 (46,000, 69,000) | Gamma | Expense list |
Maintenance in non-CR state | 375,953.99 (244,489.6, 531,322.71) | Gamma | Expense list |
Transplantation | 250,000 (200,000, 300,000) | Gamma | Experts' opinions |
Maintenance in CR state after transplantation | 399,953.99 (268,489.6, 555,322.71) | Gamma | Expense list |
non-CR/ relapse after transplantation | 1,000,000 (800,000, 1,200,000) | Gamma | Experts' opinions |
Time horizon, year | |||
Imatinib | |||
Induction therapy | 0.0795 | - | Cao 2021 [11] |
Intensive chemotherapy | 0.8164 | - | Cao 2021 [11] |
Dasatinib | |||
Induction therapy | 0.0849 | - | Cao 2021 [11] |
Intensive chemotherapy | 0.6822 | - | Cao 2021 [11] |
Utilities, QALYs | |||
CR | 0.88 (0.82, 0.93) | Beta | Lin 2019 [13] |
non-CR/ relapse | 0.76 (0.7, 0.82) | Beta | Lin 2019 [13] |
CR after transplantation (first 5 years) | 0.8 (0.74, 0.86) | Beta | Lin 2019 [13] |
CR after transplantation (second 5 years) | 0.86 (0.8, 0.91) | Beta | Lin 2019 [13] |
non-CR/ relapse after transplantation | 0.73 (0.67, 0.79) | Beta | Lin 2019 [13] |
Cost and utility
Base case analysis
Sensitivity analysis
Results
Base case results
Strategy | Total | Incremental | ICER | ||
---|---|---|---|---|---|
Cost (CNY) | QALYs | Cost (CNY) | QALYs | ||
Imatinib | 1,020,995.35 | 2.59 | - | - | - |
Dasatinib | 1,035,788.50 | 4.84 | 14,793.15 | 2.25 | 6,575.78 |