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  • Cost-Effectiveness of Lenvatinib Compared with Sorafenib for the First-Line Treatment of Advanced Hepatocellular Carcinoma in Australia

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    Accepted Manuscript (AM)
    Author(s)
    Saiyed, Masnoon
    Byrnes, Joshua
    Srivastava, Tushar
    Scuffham, Paul
    Downes, Martin
    Griffith University Author(s)
    Byrnes, Joshua M.
    Downes, Martin J.
    Saiyed, Masnoon
    Scuffham, Paul A.
    Year published
    2020
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    Abstract
    BACKGROUND AND OBJECTIVE: In the REFLECT trial, lenvatinib showed superior clinical benefits to sorafenib in terms of progression-free survival and was non-inferior for overall survival in the treatment of advanced hepatocellular carcinoma (HCC). We assessed the cost-effectiveness of lenvatinib compared with sorafenib for patients with advanced HCC in Australia. METHOD: A partitioned-survival model was built to perform a cost-effectiveness analysis comparing lenvatinib and sorafenib from an Australian health-system perspective. Survival curves were obtained from the REFLECT trial and fitted with parametric survival functions ...
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    BACKGROUND AND OBJECTIVE: In the REFLECT trial, lenvatinib showed superior clinical benefits to sorafenib in terms of progression-free survival and was non-inferior for overall survival in the treatment of advanced hepatocellular carcinoma (HCC). We assessed the cost-effectiveness of lenvatinib compared with sorafenib for patients with advanced HCC in Australia. METHOD: A partitioned-survival model was built to perform a cost-effectiveness analysis comparing lenvatinib and sorafenib from an Australian health-system perspective. Survival curves were obtained from the REFLECT trial and fitted with parametric survival functions for extrapolation purposes beyond the trial follow-up. Cost and quality-adjusted life-years (QALYs) were accrued over the 10-year time horizon of the model. Deterministic and probability sensitivity analysis (PSA) were carried out to verify the validity of the model. RESULTS: Lenvatinib incurred higher costs (A$96,325) and superior health outcomes (QALYs: 1.205), while sorafenib had lower costs (A$92,394) and inferior health outcomes (QALYs: 1.086). Thus, lenvatinib yielded an incremental cost-utility ratio of A$33,028/QALY gained. Further, the results of the PSA found that the probability of lenvatinib being cost-effective at a willingness-to-pay threshold of A$50,000/QALY was 64%. CONCLUSION: Our study found that, at current prices, lenvatinib is a cost-effective treatment option compared with sorafenib for the first-line treatment of patients with advanced HCC.
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    Journal Title
    Clinical Drug Investigation
    DOI
    https://doi.org/10.1007/s40261-020-00983-7
    Copyright Statement
    © 2020 Springer. This is an electronic version of an article published in Clinical Drug Investigation, 2020. Clinical Drug Investigation is available online at: http://link.springer.com/ with the open URL of your article.
    Note
    This publication has been entered in Griffith Research Online as an advanced online version.
    Subject
    Health economics
    Clinical sciences
    Pharmacology and pharmaceutical sciences
    Publication URI
    http://hdl.handle.net/10072/398978
    Collection
    • Journal articles

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