Cost-effectiveness analysis of donafenib and sorafenib as a first-line treatment for unresectable or meta-static hepatocellular carcinoma
OBJECTIVE To evaluate the cost-effectiveness of first-line treatment of unresectable or metastatic hepatocellu-lar carcinoma(HCC)with donafenib versus sorafenib from the perspective of China health system.METHODS Based upon a phase Ⅱ-Ⅲ clinical trial,raw data were refitted by R language and a partitioned survival model was constructed for comparing the economics of donafenib versus sorafenib using incremental cost-effectiveness ratio(ICER)as an evaluation metric.After dis-counting cost and utility values by 5％,sensitivity analysis was performed for verifying the stability of the results.RESULTS At the end of modeling,each additional quality-adjusting life years(QALYs)of donafenib versus sorafenib cost 91 861.42 yuan.It was lower than per capita gross domestic product(GDP)of China in 2022 by three folds.The results of sensitivity analysis indi-cated that cost of sorafenib versus donafenib had great impact on the results.When willing-to-pay(WTP)tripled per capita GDP of China in 2022,the economical probability of donafenib was 89.7％.CONCLUSION Donafenib is more economical than sorafenib as a first-line treatment for unresectable or metastatic HCC.
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