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Cost-Effectiveness of Donafenib as First-Line Treatment of Unresectable Hepatocellular Carcinoma in China

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Abstract

Introduction

This study aimed to evaluate the cost-effectiveness of donafenib compared to sorafenib and lenvatinib as first-line treatments for patients with advanced hepatocellular carcinoma (HCC) in China.

Methods

A partitioned survival model was developed to estimate the clinical and economic outcomes of donafenib, sorafenib, and lenvatinib for advanced HCC. The key clinical data of these targeted therapies were assessed through a network meta-analysis. The cost and health utilities were mainly collected from the literature. Quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios (ICER) were the primary outcomes. Model uncertainty was tested with one-way sensitivity analyses, scenario analyses, and probabilistic sensitivity analyses (PSA).

Results

For health outcomes, donafenib gained the highest QALYs among the three treatments, followed by lenvatinib and sorafenib (1.106, 0.999, and 0.915 QALYs, respectively). For cost, donafenib was the cheapest option, followed by sorafenib and lenvatinib ($42,116, $43,193, and $44,261). The PSA indicated that the probability of being cost-effective for donafenib was 86.98% and 93.56% when the willingness-to-pay thresholds were one and three times the gross domestic product per capita in China, respectively. The one-way sensitivity analyses and scenario analyses also found the results to be robust.

Conclusion

Compared to sorafenib and lenvatinib, donafenib was likely to be a cost-effective treatment with the highest QALYs and the lowest cost for patients with advanced HCC in China.

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Acknowledgements

Funding

This study was supported by the National Natural Science Foundation of China, grant no. 72104151. The journal's Rapid Service Fee was funded by the authors.

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

Concept and design: Haijing Guan, Sheng Han; Acquisition, analysis, or interpretation of data: Haijing Guan, Chunping Wang; Drafting of the manuscript: Haijing Guan, Chunping Wang; Critical revision of the manuscript for important intellectual content: All authors; Statistical analysis: Haijing Guan, Chunping Wang; Administrative, technical, or material support: Zhigang Zhao, Sheng Han; Supervision: Sheng Han, Zhigang Zhao. All authors approved the final version of this article.

Disclosures

Haijing Guan, Chunping Wang, Zhigang Zhao, and Sheng Han all have nothing to disclose.

Compliance with Ethics Guidelines

This article is based on previously published studies, modelling techniques and ethics committee approval is not required.

Data Availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

Author information

Authors and Affiliations

  1. Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Haijing Guan & Zhigang Zhao

  2. China Center for Health Economic Research, Peking University, Beijing, China

    Haijing Guan

  3. International Research Center for Medicinal Administration, Peking University, Beijing, China

    Chunping Wang & Sheng Han

  4. School of Pharmaceutical Sciences, Peking University, Beijing, China

    Sheng Han

Authors
  1. Haijing Guan
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Corresponding author

Correspondence to Sheng Han.

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Guan, H., Wang, C., Zhao, Z. et al. Cost-Effectiveness of Donafenib as First-Line Treatment of Unresectable Hepatocellular Carcinoma in China. Adv Ther 39, 3334–3346 (2022). https://doi.org/10.1007/s12325-022-02185-3

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  • DOI: https://doi.org/10.1007/s12325-022-02185-3

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