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Cost-Effectiveness Analysis of Dabrafenib Plus Trametinib and Vemurafenib as First-Line Treatment in Patients with BRAF V600 Mutation-Positive Unresectable or Metastatic Melanoma in China

Author

Listed:
  • Tianfu Gao

    (School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China
    Center for Social Science Survey and Data, Tianjin University, Tianjin 300072, China)

  • Jia Liu

    (School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China
    Center for Social Science Survey and Data, Tianjin University, Tianjin 300072, China)

  • Jing Wu

    (School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China
    Center for Social Science Survey and Data, Tianjin University, Tianjin 300072, China)

Abstract

Objective: To evaluate the cost-effectiveness of dabrafenib plus trametinib combination therapy versus vemurafenib as first-line treatment in patients with BRAF V600 mutation-positive unresectable or metastatic melanoma from a healthcare system perspective in China. Methods: This study employed a partitioned survival model with three health states (progression-free survival, post-progression survival and dead) to parameterize the data derived from Combi-v trial and extrapolated to 30 years. Health states’ utilities were measured by EQ-5D-3L, also sourced from the Combi-v trial. Costs including drug acquisition costs, disease management costs and adverse event costs were based on the Chinese Drug Bidding Database and physician survey in China. The primary outcomes of the model were lifetime costs, life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were conducted, respectively. Result: Dabrafenib plus trametinib is projected to increase a patient’s life expectancy by 0.95 life-years over vemurafenib (3.03 vs. 2.08) and 1.09 QALY gains (2.48 vs. 1.39) with an incremental cost of $3833. The incremental cost-effectiveness ratio (ICER) was $3511 per QALY. In the probabilistic sensitivity analyses, at a threshold of $33,357 per QALY (three times the gross domestic product (GDP) per capita in China in 2020), the probability of dabrafenib plus trametinib being cost-effective was 90%. In the deterministic sensitivity analyses, the results were most sensitive to the dabrafenib plus trametinib drug costs, vemurafenib drug costs and discount rate of cost. Conclusion: Dabrafenib plus trametinib therapy yields more clinical benefits than vemurafenib. Using a threshold of $33,357 per QALY, dabrafenib plus trametinib is very cost-effective as compared with vemurafenib in China.

Suggested Citation

  • Tianfu Gao & Jia Liu & Jing Wu, 2021. "Cost-Effectiveness Analysis of Dabrafenib Plus Trametinib and Vemurafenib as First-Line Treatment in Patients with BRAF V600 Mutation-Positive Unresectable or Metastatic Melanoma in China," IJERPH, MDPI, vol. 18(12), pages 1-13, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:12:p:6194-:d:570862
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    References listed on IDEAS

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    1. Thomas Delea & Jordan Amdahl & Alice Wang & Mayur Amonkar & Marroon Thabane, 2015. "Cost Effectiveness of Dabrafenib as a First-Line Treatment in Patients with BRAF V600 Mutation-Positive Unresectable or Metastatic Melanoma in Canada," PharmacoEconomics, Springer, vol. 33(4), pages 367-380, April.
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