scholarly journals Cost-Effectiveness of ramucirumab plus paclitaxel as a second-line therapy for advanced gastric or gastro-oesophageal cancer in China

PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0232240
Author(s):  
Sini Li ◽  
Liubao Peng ◽  
Chongqing Tan ◽  
Xiaohui Zeng ◽  
Xiaomin Wan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Oesophageal Cancer ◽  
Second Line ◽  
Second Line Therapy ◽  
Line Therapy

scholarly journals The epidemiologic impact and cost-effectiveness of new tuberculosis vaccines on multidrug-resistant tuberculosis in India and China

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chathika K Weerasuriya ◽  
Rebecca C Harris ◽  
C Finn McQuaid ◽  
Fiammetta Bozzani ◽  
Yunzhou Ruan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Multidrug Resistant ◽  
Second Line ◽  
Second Line Therapy ◽  
China And India ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Line Therapy ◽  
Mdr Tb

Abstract Background Despite recent advances through the development pipeline, how novel tuberculosis (TB) vaccines might affect rifampicin-resistant and multidrug-resistant tuberculosis (RR/MDR-TB) is unknown. We investigated the epidemiologic impact, cost-effectiveness, and budget impact of hypothetical novel prophylactic prevention of disease TB vaccines on RR/MDR-TB in China and India. Methods We constructed a deterministic, compartmental, age-, drug-resistance- and treatment history-stratified dynamic transmission model of tuberculosis. We introduced novel vaccines from 2027, with post- (PSI) or both pre- and post-infection (P&PI) efficacy, conferring 10 years of protection, with 50% efficacy. We measured vaccine cost-effectiveness over 2027–2050 as USD/DALY averted-against 1-times GDP/capita, and two healthcare opportunity cost-based (HCOC), thresholds. We carried out scenario analyses. Results By 2050, the P&PI vaccine reduced RR/MDR-TB incidence rate by 71% (UI: 69–72) and 72% (UI: 70–74), and the PSI vaccine by 31% (UI: 30–32) and 44% (UI: 42–47) in China and India, respectively. In India, we found both USD 10 P&PI and PSI vaccines cost-effective at the 1-times GDP and upper HCOC thresholds and P&PI vaccines cost-effective at the lower HCOC threshold. In China, both vaccines were cost-effective at the 1-times GDP threshold. P&PI vaccine remained cost-effective at the lower HCOC threshold with 49% probability and PSI vaccines at the upper HCOC threshold with 21% probability. The P&PI vaccine was predicted to avert 0.9 million (UI: 0.8–1.1) and 1.1 million (UI: 0.9–1.4) second-line therapy regimens in China and India between 2027 and 2050, respectively. Conclusions Novel TB vaccination is likely to substantially reduce the future burden of RR/MDR-TB, while averting the need for second-line therapy. Vaccination may be cost-effective depending on vaccine characteristics and setting.

Cost-effectiveness analysis of pressurized intraperitoneal aerosol chemotherapy (PIPAC C/D) in patients with gastric cancer and peritoneal metastasis.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 387-387
Author(s):  
Mehdi Javanbakht ◽  
Mohsen Yaghoubi ◽  
Atefeh Mashayekhi ◽  
Philipp Horvath ◽  
Alfred Koenigsrainer ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cost Effectiveness ◽  
Palliative Chemotherapy ◽  
Cost Effective ◽  
Dominant Strategy ◽  
Second Line ◽  
Second Line Therapy ◽  
Line Therapy ◽  
Upfront Therapy ◽  
Line Chemotherapy

387 Background: The efficacy of systemic chemotherapy is still highly unsatisfactory for patients with gastric cancer and peritoneal metastases (PM). The aim of this study was to assess the costs effectiveness of pressurized intraperitoneal aerosol chemotherapy with low-dose cisplatin and doxorubicin (PIPAC C/D) for advanced gastric cancer. Methods: We developed a state transition Markov Model to estimate the costs and effectiveness of the use of PIPAC C/D versus palliative chemotherapy. Intervention was assessed in two different levels including upfront therapy (PIPAC C/D plus XELOX chemotherapy versus first-line chemotherapy alone) and second line therapy (PIPAC C/D only versus second-line chemotherapy (ramucirumab monotherapy)). Data from multiple sources such as published literature and UK-based databases were used to inform the economic model. Deterministic and probabilistic sensitivity analyses were conducted to explore the impact of key parameter variation on the results. Results: For the upfront therapy the estimated total costs in the intervention and comparator arms were £33,587(SD: £2,394) and £17,477 (£927) respectively. PIPAC C/D plus XELOX led to an increase of 0.56 in QALYs. Estimated incremental cost per quality adjusted life years (QALYs) was £28,879. Result from probabilistic sensitivity analysis showed that PIPAC C/D plus XELOX is cost effective in more than 50% of Monte Carlo simulations at £30,000 threshold. For the second-line therapy, the total costs for PIPAC C/D was £15,985 (£1,391) and for the second-line palliative chemotherapy was £36,319 (£3,673). PIPAC C/D led to an increase of 0.21 in QALYs and £20,222 reduction in costs, meaning the intervention is dominant strategy in the second line therapy as it is less costly and more effective. Conclusions: The cost effectiveness results for the upfront therapy indicate that PIPAC C/D plus chemotherapy intervention is more costly and more effective and a cost effective intervention. PIPAC C/D only intervention has the potential to reduce costs and improve clinical outcomes for patients with advanced gastric cancer with peritoneal metastasis and therefore a dominant strategy.

scholarly journals Cost-Effectiveness Analysis of Trastuzumab Emtansine as Second-Line Therapy for HER2 Positive Breast Cancer in China

2020 ◽  
Author(s):  
Huahua Zhang ◽  
Yandong Zhang ◽  
Chaonan Huang ◽  
Jiangfeng Wang
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Trastuzumab Emtansine ◽  
Second Line ◽  
Her2 Positive ◽  
Second Line Therapy ◽  
Her2 Positive Breast Cancer ◽  
Line Therapy ◽  
The Cost ◽  
Positive Breast Cancer

Abstract ObjectiveTo evaluate the cost-effectiveness of trastuzumab emtansine (T-DM1) as the second-line treatment for patients with human epidermal growth factor receptor-2 (HER2) positive breast cancer from the Chinese healthcare perspective. Capecitabine (Cap), capecitabine + lapatinib (Cap+Lap), capecitabine + trastuzumab (Cap+Tra), capecitabine + trastuzumab + pertuzumab (Cap+Tra+Pre) were selected as comparators.MethodsA three-state Markov simulation model was performed. The state transition probabilities were estimated based on the results of a published network meta-analysis, and utilities were derived from the published literature. The costs populated in the model were acquired from the local charge or previously published studies. Univariate sensitive analysis and probabilistic sensitivity analyses were performed to test the robustness of the results.ResultsTreatment with T-DM1 was estimated to increase the cost by $109,683.7, $106,003.7, $94,212.2, and $63,214.9, and yield a gain of 0.544 quality-adjusted life years (QALYs), 0.383 QALYs, 0.367 QALYs, 0.087 QALYs in comparison with Cap, Cap+Lap, Cap+Tra, and Cap+Tra+Pre, respectively. Corresponding incremental cost-effectiveness ratios (ICERs) were $201,624.4, $276,772.1, $256,709.0, and $726,608.0 per QALY. The probabilities of T-DM1 as the dominant option were 0% at the WTP threshold of $30,829.3/QALY.ConclusionsT-DM1, as second-line therapy in the treatment of HER2 positive breast cancer, is not a cost-effective option in China. Given the significant clinical efficacy, an appropriate price reduction of T-DM1 is required to benefit more HER2 positive breast cancer patients.

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