Pharmacoeconomic evaluation of Bacillus Calmette-Guérin for post-TUR-BT perfusion therapy in patients with intermediate- to high-risk non-muscle invasive bladder cancer in China
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Pharmacoeconomic evaluation of Bacillus Calmette-Guérin for post-TUR-BT perfusion therapy in patients with intermediate- to high-risk non-muscle invasive bladder cancer in China
SU Zhicheng,LI Lu,YAO Qiang,et al.Pharmacoeconomic evaluation of Bacillus Calmette-Guérin for post-TUR-BT perfusion therapy in patients with intermediate- to high-risk non-muscle invasive bladder cancer in China[J].ZHONGGUO YAOFANG,2024,35(22):2773-2778.
SU Zhicheng,LI Lu,YAO Qiang,et al.Pharmacoeconomic evaluation of Bacillus Calmette-Guérin for post-TUR-BT perfusion therapy in patients with intermediate- to high-risk non-muscle invasive bladder cancer in China[J].ZHONGGUO YAOFANG,2024,35(22):2773-2778. DOI: 10.6039/j.issn.1001-0408.2024.22.12.
Pharmacoeconomic evaluation of Bacillus Calmette-Guérin for post-TUR-BT perfusion therapy in patients with intermediate- to high-risk non-muscle invasive bladder cancer in China
To evaluate the cost-effectiveness of using Bacillus Calmette-Guérin (BCG) versus epirubicin for intravesical perfusion after transurethral resection of bladder tumor (TUR-BT) in patients with intermediate- to high-risk non-muscle-invasive bladder cancer (NMIBC).
METHODS
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From the perspective of China’s health system, a Markov cohort model was constructed based on the ChiCTR-IIR-16008357 study. Quality-adjusted life years (QALYs) were used as the health outcome measure, with the willingness-to-pay(WTP) threshold set at one time the per capita gross domestic product of China in 2023 (89 358 yuan/QALY). A cost-utility analysis was used to compare the incremental cost-effectiveness ratio (ICER) of the BCG regimen relative to the epirubicin regimen for intravesical perfusion after TUR-BT in patients with intermediate- to high-risk NMIBC in China. In addition, sensitivity analysis was performed.
RESULTS
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The incremental cost of the BCG regimen compared to the epirubicin regimen was 34 309.51 yuan, with an incremental utility of 0.800 QALYs, resulting in an ICER of 42 871.33 yuan/QALY, which is below the WTP threshold. When the WTP threshold was 89 358 yuan/QALY, the probability that the BCG regimen would be acceptable was 77.70% in the probabilistic sensitivity analysis, higher than that of the epirubicin regimen, and the acceptability of the BCG regimen increased with increasing in the WTP threshold.
CONCLUSIONS
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When the WTP threshold was set at one time the per capita gross domestic product of China in 2023, compared to epirubicin, BCG used for intravesical perfusion after TUR-BT in patients with intermediate- to high-risk NMIBC demonstrated better cost-effectiveness.
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BRAY F , FERLAY J , SOERJOMATARAM I , et al . Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2018 , 68 ( 6 ): 394 - 424 .
MARIOTTO A B , ENEWOLD L , ZHAO J X , et al . Medical care costs associated with cancer survivorship in the United States [J ] . Cancer Epidemiol Biomarkers Prev , 2020 , 29 ( 7 ): 1304 - 1312 .
EBRAHIMI H , AMINI E , PISHGAR F , et al . Global,regional and national burden of bladder cancer,1990 to 2016:results from the GBD study 2016 [J ] . J Urol , 2019 , 201 ( 5 ): 893 - 901 .
FLAIG T W , SPIESS P E , ABERN M , et al . NCCN guidelines ® insights:bladder cancer,version 3.2024 [J ] . J Natl Compr Canc Netw , 2024 , 22 ( 4 ): 216 - 225 .
HUANG J , ZHANG X . Guidelines for the diagnosis and treatment of urological and andrological diseases in China:2022 edition [M ] . Beijing : Science Press , 2022 : 39 - 129 .
BABJUK M , BURGER M , COMPÉRAT E M , et al . European Association of Urology guidelines on non-muscle-invasive bladder cancer(TaT1 and carcinoma in situ): 2019 update [J ] . Eur Urol , 2019 , 76 ( 5 ): 639 - 657 .
UCHIDA A , YONOU H , HAYASHI E , et al . Intravesical instillation of Bacille Calmette-Guérin for superficial bladder cancer:cost-effectiveness analysis [J ] . Urology , 2007 , 69 ( 2 ): 275 - 279 .
BAI Z P , TANG Y Z . Effects of TURBT combined with epirubicin and hydroxycamptothecin by intravesical instillation on postoperative recurrence rate and life quality of patients with superficial bladder cancer [J ] . Med Pharm J Chin People’s Liberation Army , 2019 , 31 ( 4 ): 40 - 43 .
CHEN X J , XIA Z H , CHEN M Z , et al . Cost-effectiveness analyses of four drugs as prophylaxis for recurrence in patients with superficial bladder tumors by bladder instillation after TURBT [J ] . Chin Gen Pract , 2012 , 15 ( 19 ): 2188 - 2190 .
YANG X , DING Q . Cost-effectiveness analysis of four therapeutic schemes for carcinoma of urinary bladder [J ] . Eval Anal Drug Use Hosp China , 2001 , 1 ( 2 ): 90 - 92 .
YU H , LIN T X , LI X , et al . The efficacy and safety of BCG in the prevention of postoperative recurrence of intermediate and high-risk non-muscle invasive bladder cancer:a randomized,controlled,multi-center clinical trial:mid-term report [J ] . Chin J Urol , 2019 , 40 ( 7 ): 485 - 491 .
YU H , LI K W , HU H L , et al . The efficacy of intravesical instillation of domestic BCG versus epirubicin in the prevention of recurrence of intermediate-risk or high-risk non-muscular invasive bladder cancer and predictive factors of BCG instillation:a randomized,controlled,multi-center clinical trial with 2 years’ follow-up [J ] . Chin J Urol , 2020 , 41 ( 10 ): 724 - 730 .
BRIGGS A , CLAXTON K , SCULPHER M . Decision modelling for health economic evaluation [M ] . Oxford : Oxford University Press , 2006 : 70 - 75 .
ZHAO Z Y , WU Y W , LI M D , et al . Real-world study of efficacy and safety of BCG intravesical treatment for intermediate- and high-risk NMIBC [J ] . J Clin Urol , 2023 , 38 ( 12 ): 910 - 914,920 .
CHOU R , SELPH S , BUCKLEY D I , et al . Intravesical therapy for the treatment of nonmuscle invasive bladder cancer:a systematic review and meta-analysis [J ] . J Urol , 2017 , 197 ( 5 ): 1189 - 1199 .
FAN Y , SHI M , XIONG Z B , et al . Critical analysis on risk factors of postoperative in-hospital complications in radical cystectomy of bladder cancer [J ] . J Sichuan Univ Med Sci Ed , 2012 , 43 ( 1 ): 99 - 103 .
HE Q , ZHANG G H . Comparison of the efficacy of comprehensive bladder preservation surgery with radical cystectomy for muscle invasive bladder cancer [J ] . Oncol Prog , 2017 , 15 ( 3 ): 334 - 337 .
ZHENG W , LI X S , SONG G , et al . Comparison of laparoscopic and open cystectomy for bladder cancer:a single center of 110 cases report [J ] . Transl Androl Urol , 2012 , 1 ( 1 ): 4 - 8 .
LIU G E . Guidelines for pharmaceutical economics evalua-tion in China 2020 [M ] . Beijing : China Market Press , 2020 : 1 - 15 .
KULKARNI G S , ALIBHAI S M H , FINELLI A , et al . Cost-effectiveness analysis of immediate radical cystectomy versus intravesical Bacillus Calmette-Guérin therapy for high-risk,high-grade(T1G3)bladder cancer [J ] . Cancer , 2009 , 115 ( 23 ): 5450 - 5459 .
National Health Commission . Statistical bulletin on the development of health and health care in China in 2021 [EB/OL ] .[ 2024-09-27 ] . https://www.gov.cn/xinwen/2022-07/12/content_5700670.htm https://www.gov.cn/xinwen/2022-07/12/content_5700670.htm .
JIN Y H , ZENG X T . Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidence-based clinical practice guideline:2018 simplified version [J ] . J Mod Urol , 2019 , 24 ( 7 ): 516 - 542 .
PASTA D J , TAYLOR J L , HENNING J M . Probabilistic sensitivity analysis incorporating the bootstrap:an exam-ple comparing treatments for the eradication of Helicobacter pylori [J ] . Med Decis Making , 1999 , 19 ( 3 ): 353 - 363 .
EDLIN R , MCCABE C , HULME C , et al . Cost effectiveness modelling for health technology assessment:a practical course [M ] . Cham : Springer International Publishing , 2015 : 105 - 118 .
冯国双 . 白话统计 [M ] . 北京 : 电子工业出版社 , 2018 : 92 - 96 .
FENG G S . Vernacular statistics [M ] . Beijing : Publishing House of Electronics Industry , 2018 : 92 - 96 .
REED J F . Better binomial confidence intervals [J ] . J Mod App Stat Meth , 2007 , 6 ( 1 ): 153 - 161 .
National Bureau of Statistics . Statistical bulletin on national economic and social development of the People’s Republic of China in 2023 [EB/OL ] . [ 2024-09-27 ] . https://www.stats.gov.cn/sj/zxfb/202402/t20240228_1947915.htm https://www.stats.gov.cn/sj/zxfb/202402/t20240228_1947915.htm .
YE Z P , MA J , LIU F Y , et al . Literature tracing and conceptual analysis of 1-3 times GDP per capita as pharmacoeconomic threshold [J ] . Chin Health Econ , 2020 , 39 ( 5 ): 72 - 75 .
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