Cost-effectiveness analysis of gemcitabine plus cisplatin versus fluorouracil plus cisplatin in the first-line setting for Chinese patients with metastatic nasopharyngeal carcinoma
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A randomized phase III trial demonstrated that gemcitabine plus cisplatin (GP) prolonged progression-free survival and overall survival compared with fluorouracil plus cisplatin (FP) as first-line chemotherapy in patients with metastatic nasopharyngeal carcinoma (NPC). The cost-effectiveness analysis was designed to identify the economic option for metastatic NPC from a Chinese societal perspective.
We established a Markov model that involved three health states representing the stages of disease to simulate therapy. Survival data of clinical outcomes were derived from the trial and adjusted to quality-adjusted life years (QALYs). Transition probabilities and health utilities were obtained from the clinical trial and published literatures. The cost-effective strategy was estimated for these treatments using a willing-to-pay (WTP) threshold. A one-way sensitivity analysis was conducted to study the influences of parameters.
GP treatment group produced a gain of 0.37 QALYs with an incremental cost of $2520.80, yielding an incremental cost-effectiveness ratio (ICER) of $6812.97 per QALY, compared with FP treatment ($15,530.96 versus $13,010.16). The ICER was lower than the accepted WTP threshold, which was 3 times gross domestic product per capita of China ($25,749 per QALY).
GP regimen is more cost-effective compared with FP regimen as the first-line treatment for Chinese patients with metastatic NPC.
KeywordsCost-effectiveness Gemcitabine Fluorouracil Cisplatin Metastatic nasopharyngeal carcinoma
This work was supported by National Natural Science Foundation of China (No. 81572988) and Science and Technology Department of Sichuan Province Funding Project (Nos. 2016FZ0108 and 2018SZ0117).
Compliance with ethical standards
Conflict of interest
The authors declared no conflicts of interest in this work.
This article does not contain any studies with human participants or animals performed by any of the authors.
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