Cost‑effectiveness analysis of the addition of bevacizumab to temozolomide therapy for the treatment of unresected glioblastoma
- Authors:
- Published online on: November 14, 2019 https://doi.org/10.3892/ol.2019.11099
- Pages: 424-430
-
Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Metrics: Total
Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Abstract
Glioblastoma, a cancer that originates from astrocytes, is the most prevalent malignant glioma in the adult population. The aim of the present study was to evaluate the cost‑effectiveness of bevacizumab (BEV) as a supplement to standard temozolomide (TMZ) treatment for unresected glioblastoma. The analyzed data were from a phase II trial that showed a survival benefit following combination therapy, when compared with TMZ monotherapy. According to the clinical symptoms and disease progression, a Markov model was constructed to estimate the incremental cost‑effectiveness ratio (ICER) from a Chinese societal perspective. Health outcomes were retrieved from the GENOM 009 trial, and utility parameters were obtained from published literature. Uncertainties within the model were addressed through one‑way deterministic and probabilistic sensitivity analyses. The addition of BEV to TMZ therapy increased overall costs by $30,894.99, with a gain of 0.18 quality‑adjusted life‑years (QALYs), resulting in an ICER of $171,638.83/QALY. Both one‑way sensitivity and probabilistic sensitivity analyses confirmed that BEV/TMZ co‑treatment was not cost‑effective in the context of a $26,508.00/QALY willingness‑to‑pay (WTP) threshold. The utility of the progression‑free survival state had the most noticeable impact on the ICER. In summary, the combination of BEV and TMZ should not be considered a cost‑effective neoadjuvant treatment option for patients with unresected glioblastoma in China, from a societal perspective. However, in view of the survival benefits conferred, an appropriate price discount or the use of medical insurance could make BEV affordable for this patient population.