Cost-effectiveness analysis of utidelone plus capecitabine for metastatic breast cancer in China. (3rd June 2019)

• Record Type: Journal Article
• Authors: Liao, Mengting; Jiang, Qin; Hu, Huabin; Han, Jiaqi; She, Longjiang; Yao, Linli; Ding, Dong; Huang, Jin
• Is Part Of: Journal of medical economics. Volume 22:Number 6(2019)
• Page Start: 584
• Page End: 592
• Publication Date: 2019-06-03
• Subjects: Metastatic breast cancer -- utidelone -- capecitabine -- cost-effectiveness analysis -- Markov model; A13 -- C10; Medical care -- Cost control -- Periodicals; Medical economics -- Periodicals; 362.10941
• DOI: 10.1080/13696998.2019.1588125
• Languages: English
• ISSNs: 1369-6998

Abstract

Abstract: Objective: To estimate the cost-effectiveness of utidelone plus capecitabine therapy compared to capecitabine alone in patients with metastatic breast cancer (MBC) resistant to anthracyclines and taxanes treatment in the Chinese context and provide a reference for the marketing of utidelone in China. Methods: A Markov model was developed based on the NCT02253459 clinical trial to simulate the clinical course of patients with metastatic breast cancer who had received taxanes and anthracycline therapy. The quality-adjusted life years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) were then analyzed to evaluate the benefits. Two-parametric Weibull distribution was conducted to fit PFS and OS curves by using R. Sensitivity analyses were performed to evaluate the stability of the model designed. Results: The addition of utidelone increased the cost and QALYs by $13, 370.25 and 0.1961, respectively, resulting in an increased ICER of $68, 180.78 per QALY. The most sensitive influential parameter on ICER was the price of utidelone. At the threshold of willingness-to-pay (WTP) of $24, 380 (3 per capita GDP of China), the cost of utidelone per 30 mg of less than $18.5, $33.7, and greater than $48.8 resulted in a 100%, 50%, and 0% possibility of cost-effectiveness, respectively. The addition of utidelone was not cost-effective when it was $115.4 per 30 mg—the price of its analog paclitaxel. In consideration of varied economics levels across China, cost-effectiveness could be achieved with the price of utidelone ranging from $5.2 to $35.9. Limitations: The survival curves extended beyond the follow-up time horizon, of which data were generated not from the real analyses but from our established two-parameter Weibull survival model. Conclusion: It is recommended that the price of utidelone would be less than $18.5 per 30 mg in order to obtain cost-effectiveness for metastatic breast cancer patients resistant to anthracyclines and taxanes treatment in China.