Cost-effectiveness analysis of donafenib versus lenvatinib for first-line treatment of unresectable or metastatic hepatocellular carcinoma

ABSTRACT

Background

Donafenib and lenvatinib are approved by China National Medical Products Administration and recommended as first-line treatment of Metastatic Hepatocellular Carcinoma (HCC). The aim of this study was to assess the cost-effectiveness of donafenib compared with lenvatinib for first-line treatment of advanced HCC in China.

Methods

A partitioned survival model consisting with three health states was developed to simulate lifetime development of advanced HCC from China healthcare payer’s perspective. The lifetime costs, quality-adjusted life-years (QALYs), life-years (LYs), and incremental cost-effectiveness ratio (ICER) were calculated. The efficacy data were obtained from ZGDH3 and REFLECT trials. The cost and health outcomes were discounted at a rate of 5%. Sensitivity and scenario analyses were carried out to explore the variation of model results.

Results

Compared with lenvatinib, donafenib incurred more costs of $1500.86 and had 0.139 QALYs gained, resulting in an ICER of $10,790.18/QALY. The probability of being cost-effective was 84.9% at a willingness-to-pay threshold of gross domestic product per capita in 2020 in China ($31,499.2/QALY). Sensitive and scenario analysis results were in line with base-case analysis.

Conclusions

Donafenib appears to be a cost-effective strategy compared with lenvatinib for the first-line treatment of patients with unresectable or metastatic HCC in China.

KEYWORDS:

• China
• Cost-effectiveness analysis
• donafenib
• hepatocellular carcinoma
• lenvatinib

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

R Meng and T Zhou design the study and developed the concept and model to conduct cost-effectiveness analysis; R Meng and X Zhang reconstructed individual patient data and collected cost and utilities parameters, R Meng, M Luo and Y Qiu checked data and drafting manuscript, T Zhou critical revised the manuscript for important intellectual content. All authors reviewed and approved the final version to be published.

Ethical statement

Ethical approval and informed consent from the patients were not required in this study, because the research data is publicly available.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2022.2079498

Additional information

Funding

This paper was not funded.