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Cost-effectiveness analysis of seven treatments vs sorafenib as first-line therapy for advanced hepatocellular carcinoma in China 认领 引用
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作者 Zhi-Huan Lin Yan He +1 位作者 Hai-Xia Xu Liang Xiao 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第4期259-275,共17页
BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of primary liver cancer and represents a significant health burden in China,where selecting cost-effective first-line therapies for advanced disease rema... BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of primary liver cancer and represents a significant health burden in China,where selecting cost-effective first-line therapies for advanced disease remains critical.AIM To evaluate the cost-effectiveness of seven high-efficacy regimens for advanced HCC from the perspective of the Chinese healthcare system.METHODS A systematic network meta-analysis was conducted on 23 first-line treatment regimens from 22 phase III randomized controlled trials.Seven high-efficacy regimens were then subjected to cost-effectiveness evaluation using a Markov model.Hazard ratios for progression-free survival and overall survival specific to Chinese subgroups were preferentially employed to derive survival parameters;when unavailable,Asian subgroup data were substituted to maintain population relevance.The analysis incorporated survival data,adverse event profiles,and direct medical costs.RESULTS The network meta-analysis ranked lenvatinib plus transarterial chemoembolization(L+T)highest for both progression-free survival and overall survival[surface under the cumulative ranking curve:(1)100%;and(2)99.4%,respectively].The cost-effectiveness analysis revealed that L+T[incremental cost-effectiveness ratio=$37753.45 per quality-adjusted life year(QALY)]and rivoceranib plus camrelizumab(incremental cost-effectiveness ratio=$37198.84/QALY)were cost-effective options,both below the willingness-to-pay threshold of$37669/QALY.L+T showed the highest probability(67.9%)of being the optimal treatment option.CONCLUSION L+T emerges as the optimal first-line therapy for advanced HCC in China,offering an effective balance between clinical outcomes and cost-effectiveness. 展开更多
关键词 Hepatocellular carcinoma Cost-effectiveness Network meta-analysis First-line treatment China
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Cost-effectiveness analysis of bevifibatide for patients with acute coronary syndrome undergoing percutaneous coronary intervention in China 认领 引用
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作者 Kaijie Yao Yun Bao +4 位作者 Ying Chen Yan Zhong Mengxia Yan Wen Li Bin Wu 《Pharmacoeconomics and Policy》 2026年第1期46-53,共8页
This study evaluated the cost‑effectiveness of bevifibatide versus eptifibatide for acute coronary syndrome(ACS)patients undergoing percutaneous coronary intervention(PCI)in China.A 30‑day decision tree and 15‑year Ma... This study evaluated the cost‑effectiveness of bevifibatide versus eptifibatide for acute coronary syndrome(ACS)patients undergoing percutaneous coronary intervention(PCI)in China.A 30‑day decision tree and 15‑year Markov model simulated outcomes using matching‑adjusted indirect comparison data.Base‑case analysis used the current listed price of bevifibatide(¥1290/vial).Costs and quality‑adjusted life‑years(QALYs)were evaluated against willingness‑to‑pay(WTP)thresholds based on China's per capita gross domestic product(GDP).Base‑case results showed bevifibatide added¥12,909.24 and 0.0595 QALYs,yielding an incremental cost‑effectiveness ratio(ICER)of¥216,899/QALY.This significantly exceeds the¥76,599 WTP threshold(0.8 times GDP),indicating it is not cost‑effective.Lifetime analysis confirmed these results(ICER:¥159,541/QALY).Threshold analysis indicated a price reduction to approximately¥595/vial is required to achieve cost‑effectiveness.In conclusion,bevifibatide is not cost‑effective for ACS patients undergoing PCI in China at its current price.A substantial price reduction is necessary to align cost with clinical value,providing an evidence‑based threshold for future reimbursement negotiations. 展开更多
关键词 Cost‑effectiveness analysis Bevifibatide Eptifibatide Acute coronary syndrome Percutaneous coronary intervention
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Cost-effectiveness analysis of pancreatic enzyme replacement therapy in patients with pancreatic exocrine insufficiency in China 认领 引用
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作者 Hansoo Kim Joshua Byrnes +5 位作者 Kui-Rong Jiang Zhuan Liao Arun Jones Kyoo Kim Dafni Fragkogianni Keith J Roberts 《World Journal of Gastrointestinal Oncology》 SCIE 2025年第8期298-307,共10页
BACKGROUND Pancreatic exocrine insufficiency(PEI)leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy(PERT).Patients suffering from PEI in China are more ... BACKGROUND Pancreatic exocrine insufficiency(PEI)leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy(PERT).Patients suffering from PEI in China are more likely not to receive adequate treatment as this drug is not part of the Chinese national essential medicine list.AIM To examine the cost-effectiveness of PERT for patients suffering from PEI in China.METHODS A decision analytical Markov model was constructed to simulate the progress of patients with PEI in China.The population included in the analyses were patients suffering from PEI with advanced(non-resectable)pancreatic cancer,who have undergone surgery due to pancreatic cancer and who have undergone endoscopic treatment due to chronic pancreatitis.The cost-effectiveness analyses were undertaken from a Chinese societal perspective comparing PERT with no PERT.The incremental cost-effectiveness ratio in United States dollars per quality adjusted life year(QALY)gained is the main outcome.Input was informed by publicly available data supplemented with expert clinical advice.RESULTS The cost-effectiveness analyses estimated that PERT resulted in additional 0.45 to 2.93 QALYs at discounted costs of between 4315 dollars to 15193 dollars.This resulted in an incremental cost-effectiveness ratio of 5178 dollars to 9533 dollars per QALY.The one-way sensitivity analyses showed that the main drivers of the model were the cost of PERT and overall survival.CONCLUSION This study demonstrates that PERT is a cost-effective treatment for patients suffering from PEI in China. 展开更多
关键词 Pancreatic exocrine insufficiency Pancreatic enzyme replacement therapy Cost-effectiveness analysis National essential medicine list China
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Cost-effectiveness analysis of toripalimab plus bevacizumab versus sorafenib as first-line treatment for advanced hepatocellular carcinoma in China 认领 引用
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作者 Yize Jia Shuo Yang +1 位作者 Shan Zhao Shuo Kang 《Pharmacoeconomics and Policy》 2026年第1期19-26,共8页
This study sought to conduct an evaluation of the cost‑effectiveness of toripalimab plus bevacizumab versus sorafenib in the treatment of patients with advanced hepatocellular carcinoma(HCC)in the context of the Chine... This study sought to conduct an evaluation of the cost‑effectiveness of toripalimab plus bevacizumab versus sorafenib in the treatment of patients with advanced hepatocellular carcinoma(HCC)in the context of the Chinese healthcare system.Based on the clinical trial(Trial No.:NCT04723004),we developed a partitioned survival model to simulate patients’lifetime health outcomes and economic costs.The analysis assessed economic value by analyzing incremental cost‑effectiveness ratio(ICER)and quality‑adjusted life years(QALYs).We assessed the model’s reliability using both one‑way sensitivity analysis and probabilistic sensitivity analysis.The base case analysis indicated that toripalimab plus bevacizumab had an incremental cost of$52,351.47 and an incremental QALY of 0.24,resulting in an ICER of$220,179.20 per QALY gained.This exceeds China’s willingness‑to‑pay(WTP)threshold of$38,224 per QALY.Sensitivity analysis confirmed the robustness of the model results.The cost‑effectiveness analysis results indicated that the combination of toripalimab and bevacizumab is not cost‑effective for patients with advanced HCC in China. 展开更多
关键词 Toripalimab Bevacizumab Sorafenib Hepatocellular carcinoma Partitioned survival model Cost‑effectiveness analysis
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A Cost-Effectiveness Analysis of Magnetic Resonance Imaging Contrast Agent for Early Diagnosis of Hepatocellular Carcinoma Based on Decision Tree+Partitioned Survival Model 认领 引用
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作者 Shang Yumeng Zhang Fang Dong Li 《Asian Journal of Social Pharmacy》 CAS 2025年第2期184-194,共11页
Objective To evaluate the cost-effectiveness of gadopentetate dimeglumine(Gd-DTPA)and gadobenate dimeglumine(Gd-BOPTA)magnetic resonance imaging(MRI)contrast agents for the early diagnosis of hepatocellular carcinoma(... Objective To evaluate the cost-effectiveness of gadopentetate dimeglumine(Gd-DTPA)and gadobenate dimeglumine(Gd-BOPTA)magnetic resonance imaging(MRI)contrast agents for the early diagnosis of hepatocellular carcinoma(HCC)from the perspective of China’s healthcare system.Methods A decision tree+partitioned survival model was constructed for early diagnosis of HCC based on literature data.Taking quality-adjusted life year(QALY)as the main health outcome measure for incremental cost-effectiveness ratio(ICER)analysis,the sensitivity analysis by Monte Carlo simulation was constructed to generate corresponding tornado diagram,incremental cost-effectiveness scatter plot,and cost-effectiveness acceptability curve.Results and Conclusion The basic analysis results showed that the ICER value of Gd-BOPTA diagnostic scheme compared with Gd-DTPA diagnostic scheme was 17302.46 yuan/QALY,which is less than 1 times of China’s gross domestic product(GDP)per capita.The sensitivity analysis results showed that the cost of delayed treatment and timely treatment had a significant impact on the results.When the willingness to pay(WTP)was 1 time of GDP per capita,the probability of cost-effectiveness advantage of Gd-BOPTA diagnostic scheme was 65.30%.When the WTP value is set at 1 times of GDP per capita,Gd-BOPTA MRI has cost-effectiveness advantages for the early diagnosis of HCC. 展开更多
关键词 early HCC Gd-DTPA Gd-BOPTA cost-effectiveness analysis sensitivity analysis
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Aggregate distributional cost-effectiveness analysis:a novel tool for health economic evaluation to inform resource allocation 认领 引用
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作者 Shan Jiang Boyang Li +2 位作者 Bonny Parkinson Shunping Li Yuanyuan Gu 《Global Health Research and Policy》 CSCD 2025年第1期552-556,共5页
Health equity is a growing concern for policymakers across the globe.Conventional cost-effectiveness analysis(CEA),commonly used in evaluating health interventions,primarily focuses on the average and aggregate health... Health equity is a growing concern for policymakers across the globe.Conventional cost-effectiveness analysis(CEA),commonly used in evaluating health interventions,primarily focuses on the average and aggregate health outcomes in the targeted population,neglecting the distributional impacts on health equity.This gap calls for approaches that can quantify the impact of intervention of interest on health equity to support decision-making.Distributional Cost-Effectiveness Analysis(DCEA)offers a framework to assess the distributional impacts of health interventions.Based on DCEA,aggregate DCEA(A-DCEA)was proposed as a practical and simplified alternative to DCEA.Unlike full DCEA,which requires detailed subgroup data,A-DCEA utilizes aggregated data,making it accessible and feasible for broader use.In this commentary,we discuss the rationale for A-DCEA,outline the steps for its implementation,and highlight its applicability.The purpose of this article is to introduce A-DCEA as a pragmatic and accessible tool for evaluating the equity implications of healthcare interventions.A-DCEA can inform policymakers by incorporating equity considerations into healthcare decision-making,particularly when conducting a full DCEA is impractical due to data limitation.A-DCEA provides a valuable and accessible method for evaluating the distributional impact of interventions,promoting health equity in decision-making.Its adoption can lead to more informed health policy that considers health inequities as well as the efficient use of resources. 展开更多
关键词 Aggregate DCEA Health inequality Cost-effectiveness Familial hypercholesterolemia screening Health policy Health equity
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Cost-effectiveness analysis of tyrosine kinase inhibitors(erlotinib,gefitinib,afatinib and osimertinib)as first-line therapy for epidermal growth factor receptor-mutated advanced non-small cell lung cancer 认领 引用 被引量：12
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作者 Shaohong Luo Liangliang Dong +2 位作者 Yiyuan Li Dan Xu Min Chen 《Journal of Chinese Pharmaceutical Sciences》 CAS CSCD 2021年第3期253-263,共11页
Gefitinib,erlotinib,afatinib and osimertinib have been recommended as the first-line treatment for epidermal growth factor receptor(EGFR)-mutated advanced non-small cell lung cancer(NSCLC),whereas no studies have comp... Gefitinib,erlotinib,afatinib and osimertinib have been recommended as the first-line treatment for epidermal growth factor receptor(EGFR)-mutated advanced non-small cell lung cancer(NSCLC),whereas no studies have compared the cost-effectiveness of these four tyrosine kinase inhibitors(TKIs)simultaneously in China.In the present study,we aimed to estimate the cost-effectiveness of erlotinib,gefitinib,afatinib and osimertinib for untreated EGFR-mutated advanced NSCLC.A Markov model was constructed to compare the 10-year impact of four TKIs for patients with treatment-naive EGFR-mutated advanced NSCLC from the perspective of the Chinese medical system.Clinical data and utility values were derived from published literature,and costs were obtained from Chinese official websites.The primary output indicator was the incremental cost-effectiveness ratio(ICER).Sensitivity analyses were performed to test the robustness of the model.We found that afatinib was estimated to spend the lowest cost with minimum life-years(LYs),while osimertinib was the most expensive regimen with maximum LYs.The ICER of gefitinib versus afatinib was$732/quality-adjusted life-year(QALY),which was less than the willingness-to-pay(WTP)of$29382/QALY.Compared with gefitinib,erlotinib yielded a higher cost and a shorter lifetime,hence it was identified as a dominated strategy.Then,osimertinib was compared to gefitinib,which produced an ICER of$71330/QALY,exceeding the WTP.It suggested that gefitinib was the most cost-effective regimen as the first-line treatment for EGFR-mutated advanced NSCLC.Decreasing the osimertinib price or increasing the WTP threshold to$68558/QALY might enhance the favorability of the outcome,by which osimertinib might become more cost-effective.One-way sensitivity analysis manifested that the model was robust. 展开更多
关键词 Cost-effectiveness analysis Markov model Tyrosine kinase inhibitor Non-small cell lung cancer First-line therapy Epidermal growth factor receptor
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Cost-effectiveness analysis of different anesthesia strategies for transperineal MRI/US fusion prostate biopsy 认领 引用
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作者 Di Jin Xiao-Qi Kong +8 位作者 Ya-Juan Zhu Zong-Xin Chen Xi-Ming Wang Cai-Hua Xu Jin-Xian Pu Jian-Quan Hou Yu-Hua Huang Fu-Hai Ji Chen Huang 《Asian Journal of Andrology》 SCIE CAS CSCD 2024年第4期409-414,共6页
This study aims to conduct a cost-effectiveness analysis of three different anesthesia strategies,namely chatting while under local anesthesia(Chat-LA),total intravenous anesthesia(TIVA),and general anesthesia with la... This study aims to conduct a cost-effectiveness analysis of three different anesthesia strategies,namely chatting while under local anesthesia(Chat-LA),total intravenous anesthesia(TIVA),and general anesthesia with laryngeal mask airway(GA-LMA),employed in transperineal magnetic resonance imaging(MRI)/ultrasound(US)fusion prostate biopsy(TP-MUF-PB).A retrospective study was conducted involving 1202 patients who underwent TP-MUF-PB from June 2016 to April 2023 at The First Affiliated Hospital of Soochow University(Suzhou,China).Clinical data and outcomes,including total costs,complications,and quality-adjusted life years(QALYs),were compared.Probability sensitivity and subgroup analyses were also performed.Chat-LA was found to be the most cost-effective option,outperforming both TIVA and GA-LMA.However,subgroup analyses revealed that in younger patients(under 65 years old)and those with smaller prostate volumes(<40 ml),TIVA emerged as a more cost-effective strategy.While Chat-LA may generally be the most cost-effective and safer anesthesia method for TP-MUF-PB,personalization of anesthesia strategies is crucial,considering specific patient demographics such as age and prostate volume. 展开更多
关键词 anesthesia strategy cost-effectiveness analysis economic evaluation prostate biopsy prostate cancer
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Cost-effectiveness analysis of second-line chemotherapy strategies for patients with advanced non-squamous non-small cell lung cancer 认领 引用
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作者 Shen Lin Xin Rao +2 位作者 Yiyuan Li Xiuhua Weng Changlian Wang 《Journal of Chinese Pharmaceutical Sciences》 CAS CSCD 2020年第8期542-553,共12页
Lung cancer is the most widespread type of cancer and the primary cause of cancer-related death in the world.In this study,we aimed to analyze the cost-effectiveness of second-line chemotherapy strategies based on gem... Lung cancer is the most widespread type of cancer and the primary cause of cancer-related death in the world.In this study,we aimed to analyze the cost-effectiveness of second-line chemotherapy strategies based on gemcitabine,pemetrexed,and docetaxel for advanced non-squamous non-small cell lung cancer patients in China.A Markov model based on three states,progression-free survival,progressed survival and death,was constructed to simulate the progression of the disease in a 6-year horizon.Sensitivity analysis was performed to evaluate the robustness of the model.The primary outcome of the model was the incremental cost-effectiveness ratio at a willingness-to-pay threshold of 3×per capita GDP of China in 2018($29383).The baseline model results showed that the quality-adjusted life years over the course of the disease associated with second-line chemotherapy strategies were 0.233,0.417 and 0.272 for gemcitabine,pemetrexed and docetaxel,respectively,and the corresponding total costs were$5321.02,$12143.94,and$9479.42.Gemcitabine,pemetrexed and docetaxel resulted in the incremental cost-effectiveness ratios of$37081.09 and$106625.64 per quality-adjusted life year gained.The incremental cost-effectiveness ratio of pemetrexed and docetaxel compared with gemcitabine exceeded the willingness-to-pay threshold.One-way sensitivity analysis showed that the utility value of gemcitabine in the progressed survival state was the most influential parameter. 展开更多
关键词 Cost-effectiveness analysis Second-line chemotherapy Non-squamous non-small cell lung cancer Gemcitabine Pemetrexed Docetaxel
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The Cost-effectiveness Analysis of Percutaneous Transhepatic Metal Versus Plastic Biliary Stent Implantation for Treating Malignant Biliary Obstruction (Multiple Center Investigation) 认领 引用
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作者 郭元星 李彦豪 +5 位作者 陈勇 陈平雁 罗鹏飞 李勇 单鸿 姜在波 《The Chinese-German Journal of Clinical Oncology》 2004年第2期117-121,128,共5页
Objective: To compare metal versus plastic biliary stent implantation for treatment of malignant biliary obstruction in cost-effectiveness ratio (CER). Methods: Percutaneous transhepatic self-expandable metal stent (M... Objective: To compare metal versus plastic biliary stent implantation for treatment of malignant biliary obstruction in cost-effectiveness ratio (CER). Methods: Percutaneous transhepatic self-expandable metal stent (MS, n=61) or 10F plastic stent (PS, n=34) implantation was performed in 95 patients with malignant biliary obstruction in three hospitals of Guangdong province. All patients were followed up until death or at least one year after the procedure. Kaplan-Meier analysis was used to compare the survival and stent patency rates of the patients in the two groups. CERs of two groups were calculated. The main indexes were CERsurvival period (total cost/median survival period), CERpatency period (total cost/median patency period). Results: The total costs of treatment were 53177±3139 yuan (RMB) in MS group and 42564±4950 yuan (RMB) in PS group respectively (P>0.05). CER in MS group was superior to that in PS group (CERsurvival period was 237.4 yuan /d vs 452.6 yuan /d, respectively; CERpatency period was 231.2 yuan /d vs 472.9 yuan /d, respectively). Conclusion: The metal stent implantation is superior to the plastic stent in the CER for treatment of malignant biliary obstruction. 展开更多
关键词 radiology interventional stent biliary obstruction cost-effectiveness analysis
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Secondary hyperparathyroidism in patients undergoing maintenance hemodialysis combined with hemoperfusion Cost-effectiveness analysis of efficacy 认领 引用
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作者 Liu Qian Hu Xiu +2 位作者 Wu Xiaolong Liu Minglin Song Bin 《Science International Innovative Medicine》 2025年第2期35-40,共6页
Objective:To investigate the clinical efficacy and cost-effectiveness of combined hemodialysis(HD)and hemoperfusion(HP)therapy in managing secondary hyperparathyroidism(SHPT)in patients undergoing maintenance hemodial... Objective:To investigate the clinical efficacy and cost-effectiveness of combined hemodialysis(HD)and hemoperfusion(HP)therapy in managing secondary hyperparathyroidism(SHPT)in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 195 patients with MHD and SHPT at Deyang People's Hospital from April 2024 to April 2025 were enrolled.Patients were randomly assigned to a control group receiving standard HD treatment and an experimental group receiving HD combined with HP therapy.The experimental group underwent 1 year of observation(97 cases in the experimental group,98 cases in the control group).During treatment,changes in parathyroid hormone(PTH),serum calcium,serum phosphorus,and inflammatory factors were monitored,along with analysis of treatment-related economic benefits and safety.Results:The experimental group demonstrated significantly better reductions in PTH,serum phosphorus,and inflammatory factors compared to the control group(P<0.05).Although the total treatment cost was slightly higher,the unit cost per therapeutic effect was lower,resulting in a superior cost-effectiveness ratio.Conclusion:Combined HD and HP therapy can significantly improve SHPT-related indicators in MHD patients,demonstrating safety,controllability,and high cost-effectiveness,making it a clinically applicable and recommended treatment option. 展开更多
关键词 maintenance hemodialysis secondary hyperparathyroidism hemoperfusion cost-effect-iveness analysis
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High-resolution microendoscopy for esophageal cancer screening in China: A cost-effectiveness analysis 认领 引用 被引量：12
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作者 Chin Hur Sung Eun Choi +8 位作者 Chung Yin Kong Gui-Qi Wang Hong Xu Alexandros D Polydorides Li-Yan Xue Katherine E Perzan Angela C Tramontano Rebecca R Richards-Kortum Sharmila Anandasabapathy 《World Journal of Gastroenterology》 SCIE CAS 2015年第18期5513-5523,共11页
AIM:To study the cost-effectiveness of high-resolution microendoscopy(HRME)in an esophageal squamous cell carcinoma(ESCC)screening program in China.METHODS:A decision analytic Markov model of ESCC was developed.Separa... AIM:To study the cost-effectiveness of high-resolution microendoscopy(HRME)in an esophageal squamous cell carcinoma(ESCC)screening program in China.METHODS:A decision analytic Markov model of ESCC was developed.Separate model analyses were conducted for cohorts consisting of an averagerisk population or a high-risk population in China.Hypothetical 50-year-old individuals were followed until age 80 or death.We compared three different strategies for both cohorts:(1)no screening;(2)standard endoscopic screening with Lugol’s iodine staining;and(3)endoscopic screening with Lugol’s iodine staining and an HRME.Model parameters were estimated from the literature as well as from GLOBOCAN,the Cancer Incidence and Mortality Worldwide cancer database.Health states in the model included non-neoplasia,mild dysplasia,moderate dysplasia,high-grade dysplasia,intramucosal carcinoma,operable cancer,inoperable cancer,and death.Separate ESCC incidence transition rates were generated for the average-risk and high-risk populations.Costs in Chinese currency were converted to international dollars(I$)and were adjusted to 2012dollars using the Consumer Price Index.RESULTS:The main outcome measurements for this study were quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER).For the average-risk population,the HRME screening strategy produced 0.043 more QALYs than the no screening strategy at an additional cost of I$646,resulting in an ICER of I$11808 per QALY gained.Standard endoscopic screening was weakly dominated.Among the high-risk population,when the HRME screening strategy was compared with the standard screening strategy,the ICER was I$8173 per QALY.For both the high-risk and average-risk screening populations,the HRME screening strategy appeared to be the most cost-effective strategy,producing ICERs below the willingness-topay threshold,I$23500 per QALY.One-way sensitivity analysis showed that,for the average-risk population,higher specificity of Lugol’s iodine(>40%)and lower specificity of HRME(<70%)could make Lugol’s iodine screening cost-effective.For the high-risk population,the results of the model were not substantially affected by varying the follow-up rate after Lugol’s iodine screening,Lugol’s iodine test characteristics(sensitivity and specificity),or HRME specificity.CONCLUSION:The incorporation of HRME into an ESCC screening program could be cost-effective in China.Larger studies of HRME performance are needed to confirm these findings. 展开更多
关键词 Cost-effectiveness analysis Diagnostic imaging Endoscopy Esophageal squamous cell cancer Simulation disease model
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Cost-effectiveness analysis of population-based screening of hepatocellular carcinoma: Comparing ultrasonography with two-stage screening 认领 引用 被引量：15
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作者 Ming-Jeng Kuo Hsiu-Hsi Chen +8 位作者 Chi-Ling Chen Jean Ching-Yuan Fann Sam Li-Sheng Chen Sherry Yueh-Hsia Chiu Yu-Min Lin Chao-Sheng Liao Hung-Chuen Chang Yueh-Shih Lin Amy Ming-Fang Yen 《World Journal of Gastroenterology》 SCIE CAS 2016年第12期3460-3470,共11页
AIM: To assess the cost-effectiveness of two populationbased hepatocellular carcinoma(HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography(AUS).METHODS: In ... AIM: To assess the cost-effectiveness of two populationbased hepatocellular carcinoma(HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography(AUS).METHODS: In this study, we applied a Markov decision model with a societal perspective and a lifetime horizon for the general population-based cohorts in an area with high HCC incidence, such as Taiwan. The accuracy of biomarkers and ultrasonography was estimated from published meta-analyses. The costs of surveillance, diagnosis, and treatment were based on a combination of published literature, Medicare payments, and medical expenditure at the National Taiwan University Hospital. The main outcome measure was cost per lifeyear gained with a 3% annual discount rate. RESULTS: The results show that the mass screening using AUS was associated with an incremental costeffectiveness ratio of USD39825 per life-year gained, whereas two-stage screening was associated with an incremental cost-effectiveness ratio of USD49733 per life-year gained, as compared with no screening. Screening programs with an initial screening age of 50 years old and biennial screening interval were the most cost-effective. These findings were sensitive to the costs of screening tools and the specificity of biomarker screening.CONCLUSION: Mass screening using AUS is more cost effective than two-stage biomarker-ultrasound screening. The most optimal strategy is an initial screening age at 50 years old with a 2-year inter-screening interval. 展开更多
关键词 Two-stage biomarker-ultrasound screening One-stage abdominal ultrasonography screening Markov model Cost-effectiveness Sensitivity analysis Age
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Cost-effectiveness analysis of chemotherapy for advancedgastric cancer in China 认领 引用 被引量：20
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作者 Xin-Zu Chen Kun Jiang +5 位作者 Jian-Kun Hu Bo Zhang Hong-Feng Gou Kun Yang Zhi-Xin Chen Jia-Ping Chen 《World Journal of Gastroenterology》 SCIE CAS 2008年第17期2715-2722,共8页
AIM： To assess the economics of various chemotherapeutic regimens for advanced gastric cancer （AGC）, and to select the best cost-effective regimen for the common Chinese patients. METHODS： Data source used in this... AIM： To assess the economics of various chemotherapeutic regimens for advanced gastric cancer （AGC）, and to select the best cost-effective regimen for the common Chinese patients. METHODS： Data source used in this study was the Chinese Biomedical Disk Database. Patients were diagnosed as AGC and any regimen was eligible. Outcome measures included median survival time （MST） and percentage of complete and partial response （CR＋PR）. Economic statistics was per capita direct medical cost （DMC） of a single cycle. TreeAge Pro Healthcare 2007 software was used to carry out costeffectiveness and incremental cost-effectiveness analysis. Sensitivity analyses were applied by altering willingness- to-pay and annual discount rate, and also re-analyzed by excluding the studies with apparent heterogeneity. RESULTS： Seven retrospective economics studies on 760 patients were included. S-fluorouracil-based regimens were universal, and also some new agents were involved, such as docetaxel, paclitaxel, andoxaliplatin. By processing analysis, we could recommend etoposide, leucovorin and 5-fluorouracil （ELF） regimen as preference, with a DMC/MST ratio of 2543 RBM/11.7 mo and a DMC/CR＋PR ratio of 2543 RMB/53.3%. Uraciltegafur, etoposide and cisplatin （FEP） or 5-fluorouracil, adrimycin/epirubin and mitomycin （FAM） regimens could be regarded as optional first-line chemotherapy for AGC in common Chinese patients. With no regard for willingness-to-pay, the docetaxel, cisplatin and 5-fluorouracil （DCF） regimen could be chosen as either a first- or a second-line chemotherapy, with a DMC/CR＋PR ratio of 9979 RMB/56.3%. CONCLUSION： 5-fluorouracial regimens are still considered the mainstream for AGC, while new agents such as taxanes are optional. More randomized clinical trials are required before any mandatory recommendation of certain regimens for patients with AGC in China is made. 展开更多
关键词 Advanced gastric cancer Chemotherapy 5-fluorouracil Taxanes Cost-effectiveness
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Cost-effectiveness analysis of early veno-venous hemofiltration for severe acute pancreatitis in China 认领 引用 被引量：10
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作者 Kun Jiang Xin-Zu Chen +2 位作者 Qing Xia Wen-Fu Tang Lei Wang 《World Journal of Gastroenterology》 SCIE CAS 2008年第12期1872-1877,共6页
AIM： To determine the most cost-effective hemofiltration modality for early management of severe acute pancreatitis （SAP） in China. METHODS： We carried out a search of Pub-Medline and Chinese Biomedical Disk datab... AIM： To determine the most cost-effective hemofiltration modality for early management of severe acute pancreatitis （SAP） in China. METHODS： We carried out a search of Pub-Medline and Chinese Biomedical Disk database. Controlled clinical trials on Chinese population were included in the analysis. The four decision branches that were analyzed were： continuous or long-term veno-venous hemofiltration （CVVH/LVVH）, short-term veno-venous hemofiltration （SVVH）, SVVH plus peritoneal dialysis （PD）, and non-hemofiltration control group. The effectiveness of the technique was determined by survival rate, complications prevention and surgery preservation. The total cost of hospitalization was also assessed. RESULTS： The SVVH only technique was the least costly modality, $5809 （44449 RMB）, and was selected as the baseline treatment modality. SVVH only arm achieved the lowest C/E ratio in terms of overall survival, complications prevention and surgery preservation. In incremental cost-effectiveness analysis, the CWH/ LVVH only and the control arms were inferior to other techniques. Sensitivity analysis showed SVVH only and SVVH plus PD arms overlapped in C/survival ratio. CONCLUSION： The role of early veno-venous hemofiltration as an alternative therapy for SAP remains controversial. However, we propose that early use of short-term high-volume veno-venous hemofiltration would have a beneficial impact on the management of SAP. 展开更多
关键词 Veno-venous hemofiltration Severe acutepancreatitis Early management Cost-effectiveness Health economics
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Cost-Effectiveness Analysis of Combined Chemotherapy Regimen Containing Bedaquiline in the Treatment of Multidrug-Resistant Tuberculosis in China 认领 引用 被引量：4
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作者 XU Cai Hong QIU Ying Peng +5 位作者 HE Zi Long HU Dong Mei YUE Xiao CHEN Zhong Dan XU Yuan Yuan ZHAO Yan Lin 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2023年第6期501-509,共9页
Objective This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline(BR)and the conventional treatment regimen(CR,not containing Bedaquiline)for the treatment of adu... Objective This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline(BR)and the conventional treatment regimen(CR,not containing Bedaquiline)for the treatment of adults with multidrug-resistant tuberculosis(MDR-TB)in China.Methods A combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years.The model parameter data were synthesized from the literature,the national TB surveillance information system,and consultation with experts.The incremental cost-effectiveness ratio(ICER)of BR vs.CR was determined.Results BR(vs.CR)had a higher sputum culture conversion rate and cure rate and prevented many premature deaths(decreased by 12.8%),thereby obtaining more quality-adjusted life years(QALYs)(increased by 2.31 years).The per capita cost in BR was as high as 138,000 yuan,roughly double that of CR.The ICER for BR was 33,700 yuan/QALY,which was lower than China's 1×per capita Gross Domestic Product(GDP)in 2020(72,400 yuan).Conclusion BR is shown to be cost effective.When the unit price of Bedaquiline reaches or falls below57.21 yuan per unit,BR is expected to be the dominant strategy in China over CR. 展开更多
关键词 Bedaquiline Cost-effectiveness Multidrug-resistant tuberculosis China
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Cost-effectiveness analysis of colon cancer treatments from MOSIAC and No.16968 trials 认领 引用 被引量：4
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作者 Feng Wen Ke Yao +4 位作者 Ze-Dong Du Xiao-Feng He Peng-Fei Zhang Rui-Lei Tang Qiu Li 《World Journal of Gastroenterology》 SCIE CAS 2014年第47期17976-17984,共9页
AIM: To compare XELOX and FOLFOX4 as colon cancer adjuvant chemotherapy based on MOSAIC and No. 16968 trails from Chinese cost-effectiveness perspective. METHODS: A decision-analytic Markov model was developed to comp... AIM: To compare XELOX and FOLFOX4 as colon cancer adjuvant chemotherapy based on MOSAIC and No. 16968 trails from Chinese cost-effectiveness perspective. METHODS: A decision-analytic Markov model was developed to compare the FOLFOX4 and XELOX regimens based MOSAIC and No. 16968 trial. Five states were included in our Markov model: well (state 1), minor toxicity (state 2), major toxicity (state 3), quitting adjuvant chemotherapy (state 4), and death due to adjuvant chemotherapy (state 5). Transitions among the 5 states were assumed to be Markovian. Costs were calculated from the perspective of the Chinese health-care payer. The utility data were taken from published studies. Sensitivity analyses were used to explore the impact of uncertainty factors in this cost-effectiveness analysis. RESULTS: Total direct costs of FOLFOX4 and XELOX per patient were $ 19884.96 +/- 4280.30 and $ 18113.25 +/- 3122.20, respectively. The total fees related to adverse events per patient during the entire treatment were $ 204.75 +/- 16.80 for the XELOX group, and $ 873.72 +/- 27.60 for the FOLFOX4 group, and the costs for travel and absenteeism per patient were $ 18495.00 for the XELOX group and $ 21,352.68 for the FOLFOX4 group. The base-case analysis showed that FOLFOX4 was estimated to produce an additional 0.06 in quality adjusted life years (QALYs) at an additional cost of $ 3950.47 when compared to the XELOX regimen over the model time horizon. The cost per QALY gained was $ 8047.30 in the XELOX group, which was $ 900.98 less than in the FOLFOX4 group ($ 8948.28). The one way sensitivity analysis demonstrated that the utility for the well state and minor toxicity state greatly influenced the incremental cost-effectiveness ratio of FOLFOX4. CONCLUSION: In term of cost-comparison, XELOX is expected to dominate FOLFOX4 regimes; Therefore, XELOX provides a more cost-effective adjuvant chemotherapy for colon cancer patients in China. c 2014 Baishideng Publishing Group Inc. All rights reserved. 展开更多
关键词 Cost-effectiveness Adjuvant chemotherapy Colon cancer FOLFOX XELOX
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Cost-effectiveness analysis of treatments for metastatic castration resistant prostate cancer 认领 引用 被引量：7
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作者 Matthew E.Pollard Alan J.Moskowitz +1 位作者 Michael A.Diefenbach Simon J.Hall 《Asian Journal of Urology》 2017年第1期37-43,共7页
Objective:Treatment options for metastatic castration resistant prostate cancer(mCRPC)have expanded rapidly in recent years.Given the significant economic burden,we sought perform a cost-effectiveness analysis(CEA)of ... Objective:Treatment options for metastatic castration resistant prostate cancer(mCRPC)have expanded rapidly in recent years.Given the significant economic burden,we sought perform a cost-effectiveness analysis(CEA)of the contemporary treatment paradigm for mCRPC.Methods:We devised a treatment protocol consisting of sipuleucel-T,enzalutamide,abiraterone,docetaxel,radium-223,and cabazitaxel.We estimated number and length of treatments for each therapy using dosing schedules or progression free survival data from published clinical trials.We estimated treatment cost using billing data and Medicare reimbursement values and performed a CEA.Our analysis assumed US$100,000 per life year saved(LYS)as the threshold societal willingness to pay.Results:Incremental cost-effectiveness ratios(ICER)for strategies incorporating sipuleucel-T that were not eliminated by extended dominance exceeded the societal threshold willingnessto-pay of US$100,000 per LYS,the lowest of which was sipuleucel-T+enzalutamide+abiraterone+docetaxel at US$207,714 per LYS.Enzalutamide+abiraterone+docetaxel exhibited the most favorable ICER among strategies without sipuleucel-T at US$165,460 per LYS.Conclusion:Based on the available survival data and current costs of treatment,all treatment strategies greatly exceed a commonly assumed societal willingness-to-pay threshold of US$100,000 per LYS.Improvements in this regard can only comewith a reduction in pricing,better tailoring of treatment or significant enhancements in survival with clinical use of treatment combinations or sequences. 展开更多
关键词 Metastatic prostate cancer Costs and cost analysis Health expenditures Economics Pharmaceutical
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Cost-effectiveness analysis of tele-retinopathy of prematurity screening in Iran 认领 引用
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作者 Seyed-Farzad Mohammadi Ameneh Rahban +4 位作者 Sahel Darabeigi Nastaran Salimi Afsar Farahani Alireza Lashay Cyrus Alinia 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2021年第4期560-566,共7页
AIM:To conduct a cost-utility analysis of the teleretinopathy of prematurity(ROP)screening program against no screening.METHODS:A decision tree model was developed to identify and treat the infants with threshold ROP ... AIM:To conduct a cost-utility analysis of the teleretinopathy of prematurity(ROP)screening program against no screening.METHODS:A decision tree model was developed to identify and treat the infants with threshold ROP through the tele-screening system compared with no screening program from the societal perspective.We used the quality adjusted life years(QALY)index to measure the scenarios’effectiveness,which was discounted for the future years by 0.058.One hundred twenty-six randomly selected newborns with ROP required treatment were investigated to extract the treatment information.We considered the direct medical and non-medical costs in cost calculations analysed by the bottom-up approach.The figures of the model’s inputs were calculated using the Monte Carlo simulation that generated 1000 random iteration of the data,and a one-way sensitivity analysis was performed on the model to cope with the potential uncertainties.RESULTS:The total and per capita needed the budget to establish a tele-ROP screening system were estimated at over 1.5 million and 35.13 USD,respectively.The total cost of identifying and treating an ROP case in tele-screening and no screening strategies were obtained as 108.72 and 63.52 USD,respectively,and their lifetime discounted QALY gained were calculated as 15.39 and 15.11,respectively.Therefore,incremental cost-effectiveness ratio(ICER)of tele-screening strategy against the competitive strategy was achieved as 161.43 USD.CONCLUSION:Tele-ROP screening program is one of the most cost-effective interventions in the Iranian health system and has a high priority to receive a budget for implementation. 展开更多
关键词 cost-utility analysis incremental cost-effectiveness ratio quality adjusted life years tele-retinopathy of prematurity
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Cost-effectiveness Analysis of Insulin Degludec and Liraglutide Injection in the Treatment of Type 2 Diabetes 认领 引用
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作者 Sun Quan Zhang Fang Dong Li 《Asian Journal of Social Pharmacy》 2023年第3期281-295,共15页
Objective To analyze the cost-effectiveness of insulin degludec and liraglutide injection(IDegLira)compared with insulin glargine plus insulin aspart(IGar plus IAsp)in the treatment of type 2 diabetes mellitus(T2DM)ba... Objective To analyze the cost-effectiveness of insulin degludec and liraglutide injection(IDegLira)compared with insulin glargine plus insulin aspart(IGar plus IAsp)in the treatment of type 2 diabetes mellitus(T2DM)based on the price of IDegLira before and after it was successfully admitted to the National Reimbursable Drug List(NRDL).Methods Cost and effectiveness parameters were obtained through systematic retrieval from PubMed,ScienceDirect,CNKI,and Wanfang database.A cost-effectiveness analysis(CEA)model was established to analyze the economics using IDegLira for T2DM patients with 1 to 5 years of medication.Results and Conclusion Before IDegLira was admitted to NRDL,its economic advantages over the IGlar plus Iasp regimen became more significant as patients’medication time prolonged.After being admitted to NRDL,with 1 year of medication,the medical cost of IDegLira decreased by 2853.91 yuan and the quality adjusted life years(QALY)increased by 0.12055 than IGar plus IAsp.The sensitivity analysis was highly consistent with the results of the baseline result.After being admitted to NRDL,for patients with T2DM who have poor blood glucose control,IDegLira is absolutely an economic advantage scheme compared with IGar plus IAsp. 展开更多
关键词 insulin degludec and liraglutide injection insulin glargine insulin aspart cost-effectiveness analysis
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