Cost-effectiveness analysis of venetoclax plus azacitidine for naive acute myeloid leukemia
OBJECTIVE To evaluate the cost-effectiveness of venetoclax(VEN)plus azacitidine(AZA)versus AZA monotherapy as a first-line treatment for acute myeloid leukemia from the perspective of Chinese health system.METHODS A Markov model was constructed based upon VIALE-A trial for simulating treatment cost,quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER).Deterministic sensitivity analysis(DSA)and probabilistic sensitivity analysis(PSA)were performed for testing the uncertainty of basic results.RESULTS The results of basic analysis showed that the cost of VEN plus AZA increased by 274 776.43 yuan and gained 1.13 more QALYs than azacitidine group.ICER was 243 056.96 yuan/QALY.It was lower than willing-to-pay(WTP)based upon three folds China's per capita gross domestic product(GDP)in 2022;DSA revealed that the first three factors with the greatest impact on ICER were utility value of EFS with CR/CRi,dis-count rate and cost of VEN.And fluctuation of utility value and discount rate of EFS with CR/CRi might change the conclusion;PSA indicated that probability of VEN plus AZA was more cost-effective at 69％under the value of current WTP.CONCLUSION VEN plus AZA versus AZA monotherapy in the first-line treatment for acute myeloid leukemia is more cost-effective when WTP triples per capita GDP of China in 2022.
NETL
NSTL
万方数据
