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A Markov model-based cost-effectiveness analysis comparing zanubrutinib to ibrutinib for treating relapsed and
Rongqi Li1,2, Chenxiang Wang1, Zhongjiang Ye1,2
1Department of Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Insights
Zanubrutinib is more cost-effective than ibrutinib for chronic lymphocytic leukemia patients in China and the US. This analysis of relapsed and refractory CLL demonstrates zanubrutinib’s value for payers.
Area of Science:
- Oncology
- Health Economics
- Pharmacoeconomics
Background:
- Chronic lymphocytic leukemia (CLL) is a common B-cell malignancy.
- Relapsed and refractory CLL presents treatment challenges.
- Evaluating new therapies like zanubrutinib against established options like ibrutinib is crucial for healthcare systems.
Purpose of the Study:
- To assess the cost-effectiveness of zanubrutinib versus ibrutinib for relapsed/refractory CLL.
- To provide a payer's perspective on treatment costs and outcomes in China and the US.
Main Methods:
- Markov models were utilized for comparative analysis.
- Clinical data were sourced from the ALPINE study.
- Key outcomes included cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER).
Main Results:
- Zanubrutinib demonstrated cost savings and improved QALYs compared to ibrutinib in both regions.
- The ICER for zanubrutinib was $-88,068.16/QALY in China and $-284,485.45/QALY in the US.
- Results indicate zanubrutinib is below the willingness-to-pay threshold in China and cost-effective in the US.
Conclusions:
- Zanubrutinib offers superior cost-effectiveness for Chinese payers managing relapsed/refractory CLL.
- Zanubrutinib presents a more affordable treatment option for US payers within established thresholds.
- The findings support zanubrutinib as a valuable therapeutic choice for CLL management.
Objective:
This article examined the cost-effectiveness of zanubrutinib and ibrutinib for managing relapsed and refractory chronic lymphocytic leukemia from the viewpoint of payers in China and the US.
Methods:
Markov models were employed to conduct comparisons. Baseline characteristics and clinical data were extracted from the ALPINE study. The cost-effectiveness outcome indicators encompassed cost, quality-adjusted life years, and the incremental cost-effectiveness ratio.
Results:
The Markov model analysis revealed that the zanubrutinib group incurred an incremental cost per patient of $-24,586.53 compared to the ibrutinib group. The zanubrutinib group exhibited an incremental utility per capita of 0.28 quality-adjusted life years, resulting in an incremental cost-effectiveness ratio of $-88,068.16 per quality-adjusted life year, which is lower than the payment threshold in China. The willingness-to-pay value in China for 2022 was three times the country's gross domestic product per capita. In the US, patients in the zanubrutinib group experienced per capita incremental costs of $-79,421.56, per capita incremental utility of 0.28 quality-adjusted life years, and an incremental cost-effectiveness ratio of $-284,485.45 per quality-adjusted life year.
Conclusion:
For Chinese payers, zanubrutinib exhibited superior cost-effectiveness compared to ibrutinib. Zanubrutinib proved to be a more affordable option for US payers when considering the payment threshold.
