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Economic Evaluation of Sintilimab Plus Bevacizumab Versus Sorafenib as a First-line Treatment for Unresectable Hepatocellular Carcinoma

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Abstract

Introduction

This study aimed to evaluate the cost-effectiveness of sintilimab plus bevacizumab versus sorafenib as a first-line treatment for unresectable hepatocellular carcinoma (HCC) in China to provide economic evidence to inform health decision making.

Methods

We performed an economic evaluation from the perspective of the Chinese healthcare system using a partitioned survival model with three mutually exclusive health states: progression free, post-progression, and death. Efficacy data were obtained from the ORIENT-32 clinical trial and extrapolated to the lifetime horizon. Cost and utility values were derived from published studies and online price databases. The primary outcomes of the model were quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were carried out to verify the robustness of the model results.

Results

Compared with sorafenib, sintilimab plus bevacizumab incurred a higher lifetime cost ($33,766 vs. $23,294) and yielded more QALYs (1.428 vs. 0.928 QALYs). The ICER for sintilimab plus bevacizumab was $20,968/QALY and lower than the willingness-to-pay threshold of $33,592. The results of sensitivity analysis showed that ICER values were most sensitive to the subsequent treatment cost of the sorafenib group after progression and the price of bevacizumab. In the scenario analysis, the ICER was $4191/QALY when a 7.5 mg/kg dose of bevacizumab was applied in the model.

Conclusions

Compared with sorafenib, the sintilimab plus bevacizumab combination is likely to be a cost-effective option for patients with unresectable HCC in China.

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Acknowledgements

Funding

This study, as well as the journal’s Rapid Service Fees, was funded by Innovent Biologics, Inc., and supported by the Fundamental Research Funds for the Central Universities (no. 2632022PY03). The funders were not involved in the study design, collection, analysis, interpretation of data, and the writing and the publication of this work.

Medical Writing and Editorial Assistance

Language editing support was provided by the “Nature research editing service” of Springer Nature and funded by Innovent Biologics, Inc.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Author Contributions

Ting Zhou, Hong Chao Li and Aixia Ma conceived and designed this work. Ting Zhou, Aixia Ma, Yingdan Cao acquired the data. Ting Zhou, Hong Chao Li, Xintian Wang, Zijing Wang and Lan Yang analyzed the data. Hong Chao Li and Aixia Ma supervised the study and acquired funding. Ting Zhou, Xintian Wang, Yingdan Cao, Lan Yang prepared the original manuscript. Hong Chao Li, Aixia Ma revised and edited the manuscript. All authors reviewed, read and approved the final version of the manuscript.

Disclosures

Ting Zhou, Yingdan Cao, Xintian Wang, Lan Yang, Zijing Wang, Aixia Ma and Hong Chao Li declare no other potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Compliance with Ethics Guidelines

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Informed consent from the patients was not required in this study because the research data is publicly available. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Data Availability

All data analyzed during this work were included in this article.

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Authors and Affiliations

  1. School of International Pharmaceutical Business, China Pharmaceutical University, No. 639 Longmian Avenue, Nangjing, 211198, Jiangsu, China

    Ting Zhou, Yingdan Cao, Xintian Wang, Lan Yang, Zijing Wang, Aixia Ma & Hongchao Li

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  1. Ting Zhou
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Correspondence to Aixia Ma or Hongchao Li.

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Cite this article

Zhou, T., Cao, Y., Wang, X. et al. Economic Evaluation of Sintilimab Plus Bevacizumab Versus Sorafenib as a First-line Treatment for Unresectable Hepatocellular Carcinoma. Adv Ther 39, 2165–2177 (2022). https://doi.org/10.1007/s12325-022-02079-4

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  • DOI: https://doi.org/10.1007/s12325-022-02079-4

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