Cost-utility analysis of rezvilutamide for high-volume metastatic hormone sensitive prostate cancer
OBJECTIVE To evaluate the cost-effectiveness of rezvilutamide versus apalutamide for high-volume metastatic hormone-sensitive prostate cancer(mHSPC)for Chinese patients and to provide economic rationales for clinical use of drugs.METHODS Cost-utility analysis was performed with a partitioned survival model.Progression-free survival(PFS)was exam-ined by radiographic progression-free survival(rPFS)and serum progression-free prostate-specific antigen(PSA)progression.Also overall survival(OS)was analyzed.All clinical,utility and cost parameters were derived from clinical trials,published litera-tures and market surveys.Finally the cost-effectiveness of rezvilutamide for high-volume mHSPC was calculated under a thresh-old of one-time gross domestic product per capita in China[GDP(85 698 yuan,2022)].RESULTS The results of base-case analysis indicated that,as compared with apalutamide,rezvilutamide resulted in a lifetime cost to the Chinese health care system of ¥75 387 per patient for high-volume mHSPC.However,there was an additional 1.31 QALYs.With a gain of ICER at ¥57 565/QALY,rezvilutamide was cost-effective at a cost-effectiveness threshold of ¥85 698 per QALY in 2022(one-time GDP per capita).Base-case analysis was most sensitive to OS hazard ratio of rezvilutamide versus apalutamide.With a cost-effectiveness threshold of one-time GDP per capita,the cost-effective probability of revirutamide was 60.1％.When PFS was defined as serum-free PSA progression,rezvilutamide also had an economic advantage over apalutamide.CONCLUSION Revirutamide is more cost-effective than apalutamide for Chinese patients with high-volume mHSPC.
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