Objective The aim of this study is to evaluate the cost-effectiveness of teriflunomide and fingolimod in relapsing-remitting patients in the first-line treatment from the perspective of the Chinese health system perspective.Methods A Markov model was developed to evaluate the cost effectiveness of disease-modifying drugs (DMDs) from the Chinese health system perspective.Cost input includes medication, follow-up, nursing, recurrence treatment and adverse reaction management.Treatment effects, including monthly confrmed disability worsening and annualized relapse rate.The output result was ICER and the threshold of willingness to pay(WTP) was three times per capita GDP.One-way sensitivity analysis and probability sensitivity analysis are carried out to test the stability of the model results.Results In the context of medical insurance with Chinese characteristics.The total cost of treatment with teriflunomide was ¥423,816.61, and the total cost of treatment with fingolimod was ¥656,055.95.The cumulative QALYs of teriflunomide was 5.14, and the cumulative QALYs of fingolimod was 5.25.The ICER value of Fingolimod and Liflunomide is ¥2139444.61/QALY, which is higher than WTP , so teriflunomide has a dominant advantage.Sensitivity analysis proves that the model was stable.Conclusion From the perspective of Chinese health system perspective, teriflunomide is the more cost-effective of the two interventions.
Background: Treatment with trametinib plus dabrafenib for patients exhibiting metastatic BRAF V600-mutated melanoma has been approved in China.Method: We developed a Markov model to evaluate and compare the cost-effectiveness of trametinib plus dabrafenib against vemurafenib. Information on clinical situations, the rate of adverse reactions, follow-up treatments, and estimated transition probabilities were derived from the results of a clinical trial that compared treatment with trametinib plus dabrafenib against vemurafenib alone. A one-way sensitivity analysis and a probabilistic sensitivity analysis were conducted to assess the influence of uncertainty on the key model.Result: Treatment with trametinib plus dabrafenib for one patient in the treatment period was estimated to cost CNY 332 294, and yield a total gain of 16.6 quality-adjusted life years (QALYs). Compared with vemurafenib, treatment involving trametinib plus dabrafenib yielded additional 3.96 QALYs, resulting in a unit cost-effectiveness of CNY 27 460 per QALY. Sensitivity analysis shows that the results are reliable.Conclusion:From the perspective of China's health system, applying China's per-capita GDP in 2020 as the threshold of willingness-to-pay, it is cost-effective to treat metastatic melanoma patients exhibiting BRAF V600 mutation with dabrafenib plus trametinib.
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