Monday, July 15, 2024

Cost-Effectiveness Analysis of Sotorasib in China for Advanced KRASG12C-Mutant NSCLC

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The affordability of sotorasib, a treatment for advanced KRASG12C-mutant non-small cell lung cancer (NSCLC), was scrutinized through a cost-effectiveness analysis. This study examined the economic feasibility from both the Chinese healthcare system’s and patients’ perspectives, aiming to establish a price point that aligns with the incremental cost-effectiveness ratios (ICERs) below preset willing-to-pay (WTP) thresholds. Results indicated significant variations in affordable pricing at both national and provincial levels, with implications for future drug pricing and reimbursement policies in China.

A comprehensive Markov model with a 20-year horizon and 21-day cycles was employed to analyze the cost-effectiveness of sotorasib. Data sources included the CodeBreaK 200 clinical trial, existing literature, national databases, and local hospital records. The primary focus was on determining the affordable prices of sotorasib that would keep its ICERs below the predefined WTP thresholds compared to docetaxel. Sensitivity analyses were conducted to test the robustness of the model.

National and Provincial Pricing

From the national perspective, the study found that to make sotorasib affordable, its price should not exceed US$0.04673 per mg for the Chinese healthcare system and US$0.03231 per mg for patients. These figures translate to approximately $1346 and $931 per box (120 mg × 240 pieces), respectively. At the provincial level, the price ceiling varied significantly. For the healthcare system, it ranged between $0.04084 to $0.08061 per mg, while for patients, it fluctuated between $0.02642 to $0.06620 per mg.

Sensitivity and Probabilistic Analyses

Probabilistic sensitivity analyses demonstrated that as the price of sotorasib decreased, its probability of being deemed cost-effective increased. This underscores the importance of setting a competitive price to ensure broader accessibility and adoption within the Chinese healthcare system.

Key Inferences

– Sotorasib’s affordability varies significantly between national and provincial levels.
– Lowering the price enhances the likelihood of the drug being cost-effective.
– Policymakers should consider these findings for future drug pricing and reimbursement decisions.

The study concludes that sotorasib could be a cost-effective treatment option for advanced KRASG12C-mutant NSCLC in China. The pharmaco-economic evidence provided by this research is crucial for guiding the pricing strategies of upcoming drugs and determining their potential inclusion in the National Reimbursement Drugs List.

Original Article: Adv Ther. 2024 Jun 18. doi: 10.1007/s12325-024-02908-8. Online ahead of print.

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