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Cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in France

BACKGROUND AND AIMS: The IMbrave150 clinical trial assessed the efficacy and safety of atezolizumab in combination with bevacizumab (ATZ+BVA) versus sorafenib in adults with advanced/unresectable hepatocellular carcinoma, who have not received prior systemic treatment. Our aim was to assess the cost...

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Autores principales: Gaugain, Loïg, Cawston, Hélène, Dubois de Gennes, Coline, Sanchez Alvares, Javier, Nahon, Pierre, Mazaleyrat, Benjamin, Le Dissez, Clément
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9847974/
https://www.ncbi.nlm.nih.gov/pubmed/36652428
http://dx.doi.org/10.1371/journal.pone.0280442
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author Gaugain, Loïg
Cawston, Hélène
Dubois de Gennes, Coline
Sanchez Alvares, Javier
Nahon, Pierre
Mazaleyrat, Benjamin
Le Dissez, Clément
author_facet Gaugain, Loïg
Cawston, Hélène
Dubois de Gennes, Coline
Sanchez Alvares, Javier
Nahon, Pierre
Mazaleyrat, Benjamin
Le Dissez, Clément
author_sort Gaugain, Loïg
collection PubMed
description BACKGROUND AND AIMS: The IMbrave150 clinical trial assessed the efficacy and safety of atezolizumab in combination with bevacizumab (ATZ+BVA) versus sorafenib in adults with advanced/unresectable hepatocellular carcinoma, who have not received prior systemic treatment. Our aim was to assess the cost-effectiveness of ATZ+BVA versus sorafenib in France based on an updated prices and considering French National real-world data, to confirm the initial recommendations from the Heath Technology Assessment submission published in 2021, and provide additional visibility to decision-makers reflecting current clinical practice. METHODS: A partition survival model was developed to project clinical outcomes, quality of life, and costs of patients with HCC treated with ATZ+BVA versus sorafenib over a lifetime horizon. Survival outcomes were extrapolated via parametric functions for both treatment strategies. Quality of life (EQ-5D-5L, French tariffs) were sourced from IMbrave150. The Guyot method was considered as a scenario analysis by integrating retrospective real-world data extracted from the French Health Insurance Database to refine long term survival extrapolations. RESULTS: In the reference case, ATZ+BVA was associated with 0.61 additional Quality Adjusted Life Years (QALYs) compared to sorafenib (1.95 vs 1.35), and an incremental cost of €92,704. The incremental cost-utility ratio (ICUR) was 152,974 €/QALY gained. Adjusting the survival curves with French external evidence led to a 14% ICUR reduction (131,163 €/QALY). CONCLUSIONS: ATZ+BVA is a cost-effective strategy based on the range recently published for the value of a QALY in France and offers better chances of survival to patients.
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spelling pubmed-98479742023-01-19 Cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in France Gaugain, Loïg Cawston, Hélène Dubois de Gennes, Coline Sanchez Alvares, Javier Nahon, Pierre Mazaleyrat, Benjamin Le Dissez, Clément PLoS One Research Article BACKGROUND AND AIMS: The IMbrave150 clinical trial assessed the efficacy and safety of atezolizumab in combination with bevacizumab (ATZ+BVA) versus sorafenib in adults with advanced/unresectable hepatocellular carcinoma, who have not received prior systemic treatment. Our aim was to assess the cost-effectiveness of ATZ+BVA versus sorafenib in France based on an updated prices and considering French National real-world data, to confirm the initial recommendations from the Heath Technology Assessment submission published in 2021, and provide additional visibility to decision-makers reflecting current clinical practice. METHODS: A partition survival model was developed to project clinical outcomes, quality of life, and costs of patients with HCC treated with ATZ+BVA versus sorafenib over a lifetime horizon. Survival outcomes were extrapolated via parametric functions for both treatment strategies. Quality of life (EQ-5D-5L, French tariffs) were sourced from IMbrave150. The Guyot method was considered as a scenario analysis by integrating retrospective real-world data extracted from the French Health Insurance Database to refine long term survival extrapolations. RESULTS: In the reference case, ATZ+BVA was associated with 0.61 additional Quality Adjusted Life Years (QALYs) compared to sorafenib (1.95 vs 1.35), and an incremental cost of €92,704. The incremental cost-utility ratio (ICUR) was 152,974 €/QALY gained. Adjusting the survival curves with French external evidence led to a 14% ICUR reduction (131,163 €/QALY). CONCLUSIONS: ATZ+BVA is a cost-effective strategy based on the range recently published for the value of a QALY in France and offers better chances of survival to patients. Public Library of Science 2023-01-18 /pmc/articles/PMC9847974/ /pubmed/36652428 http://dx.doi.org/10.1371/journal.pone.0280442 Text en © 2023 Gaugain et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Gaugain, Loïg
Cawston, Hélène
Dubois de Gennes, Coline
Sanchez Alvares, Javier
Nahon, Pierre
Mazaleyrat, Benjamin
Le Dissez, Clément
Cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in France
title Cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in France
title_full Cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in France
title_fullStr Cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in France
title_full_unstemmed Cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in France
title_short Cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in France
title_sort cost-utility analysis of atezolizumab with bevacizumab in untreated unresectable or advanced hepatocellular carcinoma in france
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9847974/
https://www.ncbi.nlm.nih.gov/pubmed/36652428
http://dx.doi.org/10.1371/journal.pone.0280442
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