Abstract:
OBJECTIVE To evaluate the economics of different dosage regimens of carfilzomib in the treatment of relapsed/refractory multiple myeloma(RRMM) from the perspective of the Chinese healthcare system.
METHODS A Markov model encompassing three health states including “progression-free” “progressed” and “dead”, which was constructed using clinical trial data and relevant literature. The cycle length was set at one month, simulating the disease progression of RRMM patients over a 10-year period. Cost and utility data were discounted at a rate of 5%. The incremental cost-utility ratio(ICUR) was used as the evaluation metric, with the willingness-to-pay(WTP) threshold set at 1−3 times the per capita gross domestic product(GDP) of China in 2024(ranging from 95 749 yuan to 287 247 yuan). One-way sensitivity analysis was conducted to assess the stability of the model results when parameters were varied.
RESULTS The base-case analysis revealed that The Kd27 regimen(carfilzomib 27 mg·m−2 twice weekly+dexamethasone, n=238) and the Kd70 regimen(carfilzomib 70 mg·m−2 once weekly+dexamethasone, n=240) were high cost, high health benefit strategies, compared to the Kd56 regimen(carfilzomib 56 mg·m−2 twice weekly+dexamethasone, n=464). The ICUR values for Kd27 and Kd70 were 211 201.66 yuan·(quality-adjusted life years, QALYs)−1 and 252 181.96 yuan·QALYs−1, respectively. One-way sensitivity analysis indicated that the utility value during progressive free survival was a key factor influencing the overall economic evaluation results. The ICUR exceeded the WTP threshold only at the upper bound of this parameter, while remaining below it across all other parameter ranges, confirming the robustness of our model-based conclusions.
CONCLUSION Within the Chinese healthcare insurance system, different doses of caffezomib in the treatment of RRMM, compared with Kd56, Kd27 and Kd70 have certain advantages in effectiveness and economy, and KD27 has the best cost-effectiveness. Patients may choose an appropriate treatment regimen based on their individual needs and doctor’s recommendations.
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