Cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer

OBJECTIVE: The TOPAZ-1 trial reported a significant survival benefit of durvalumab in combination with chemotherapy for the first-line treatment of biliary tract cancer (BTC). However, no studies have evaluated the economics of this treatment option. The aim of this study was to assess the cost effe...

Descripción completa

Detalles Bibliográficos
Autores principales: Ye, Zhuo-miao, Xu, Zhe, Li, Huan, Li, Qian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9950513/
https://www.ncbi.nlm.nih.gov/pubmed/36844853
http://dx.doi.org/10.3389/fpubh.2023.1046424
_version_ 1784893181276454912
author Ye, Zhuo-miao
Xu, Zhe
Li, Huan
Li, Qian
author_facet Ye, Zhuo-miao
Xu, Zhe
Li, Huan
Li, Qian
author_sort Ye, Zhuo-miao
collection PubMed
description OBJECTIVE: The TOPAZ-1 trial reported a significant survival benefit of durvalumab in combination with chemotherapy for the first-line treatment of biliary tract cancer (BTC). However, no studies have evaluated the economics of this treatment option. The aim of this study was to assess the cost effectiveness of durvalumab plus chemotherapy compared to placebo plus chemotherapy from the perspective of US and Chinese payers. METHODS: Based on clinical data from the TOPAZ-1 trial, a Markov model was developed to simulate 10-year life expectancy and total healthcare costs for patients with BTC. The treatment group received durvalumab in combination with chemotherapy and the control group received placebo plus chemotherapy. The primary outcomes analyzed included quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Uncertainty in the analysis results was assessed by sensitivity analysis. RESULTS: For US payers, the placebo plus chemotherapy group had a total cost of $56,157.05 and a utility of 1.10 QALYs, while the durvalumab plus chemotherapy group had a total cost of $217,069.25, a utility of 1.52 QALYs, resulting in an ICER of $381,864.39/QALY. For Chinese payers, the ICER of durvalumab plus chemotherapy group was $367,608.51/QALY. Sensitivity analysis showed that the analysis was most sensitive to the price of durvalumab. For US and Chinese payers, under the respective willing to pay thresholds, the likelihood of the durvalumab plus chemotherapy arm being cost-effective was 0%. CONCLUSIONS: Both in China and in the US, durvalumab in combination with chemotherapy is not a cost-effective option for the first-line treatment of BTC compared with chemotherapy.
format Online
Article
Text
id pubmed-9950513
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-99505132023-02-25 Cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer Ye, Zhuo-miao Xu, Zhe Li, Huan Li, Qian Front Public Health Public Health OBJECTIVE: The TOPAZ-1 trial reported a significant survival benefit of durvalumab in combination with chemotherapy for the first-line treatment of biliary tract cancer (BTC). However, no studies have evaluated the economics of this treatment option. The aim of this study was to assess the cost effectiveness of durvalumab plus chemotherapy compared to placebo plus chemotherapy from the perspective of US and Chinese payers. METHODS: Based on clinical data from the TOPAZ-1 trial, a Markov model was developed to simulate 10-year life expectancy and total healthcare costs for patients with BTC. The treatment group received durvalumab in combination with chemotherapy and the control group received placebo plus chemotherapy. The primary outcomes analyzed included quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Uncertainty in the analysis results was assessed by sensitivity analysis. RESULTS: For US payers, the placebo plus chemotherapy group had a total cost of $56,157.05 and a utility of 1.10 QALYs, while the durvalumab plus chemotherapy group had a total cost of $217,069.25, a utility of 1.52 QALYs, resulting in an ICER of $381,864.39/QALY. For Chinese payers, the ICER of durvalumab plus chemotherapy group was $367,608.51/QALY. Sensitivity analysis showed that the analysis was most sensitive to the price of durvalumab. For US and Chinese payers, under the respective willing to pay thresholds, the likelihood of the durvalumab plus chemotherapy arm being cost-effective was 0%. CONCLUSIONS: Both in China and in the US, durvalumab in combination with chemotherapy is not a cost-effective option for the first-line treatment of BTC compared with chemotherapy. Frontiers Media S.A. 2023-02-10 /pmc/articles/PMC9950513/ /pubmed/36844853 http://dx.doi.org/10.3389/fpubh.2023.1046424 Text en Copyright © 2023 Ye, Xu, Li and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Ye, Zhuo-miao
Xu, Zhe
Li, Huan
Li, Qian
Cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer
title Cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer
title_full Cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer
title_fullStr Cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer
title_full_unstemmed Cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer
title_short Cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer
title_sort cost-effectiveness analysis of durvalumab plus chemotherapy as first-line treatment for biliary tract cancer
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9950513/
https://www.ncbi.nlm.nih.gov/pubmed/36844853
http://dx.doi.org/10.3389/fpubh.2023.1046424
work_keys_str_mv AT yezhuomiao costeffectivenessanalysisofdurvalumabpluschemotherapyasfirstlinetreatmentforbiliarytractcancer
AT xuzhe costeffectivenessanalysisofdurvalumabpluschemotherapyasfirstlinetreatmentforbiliarytractcancer
AT lihuan costeffectivenessanalysisofdurvalumabpluschemotherapyasfirstlinetreatmentforbiliarytractcancer
AT liqian costeffectivenessanalysisofdurvalumabpluschemotherapyasfirstlinetreatmentforbiliarytractcancer