Cost-effectiveness Analysis of Bevacizumab Combined with Standard Chemotherapy in Patients with Recurrent Cervical Cancer

OBJECTIVE To evaluate the cost-effectiveness of bevacizumab(BEV) combined with standard chemotherapy and standard chemotherapy only for patients with persistent or recurrent cervical cancer. METHODS According to the disease progression of patients with metastatic cervical cancer, the Markov model was chosen to evaluate the economics of the two chemotherapy regimens. The model included three mutually exclusive health states:PFS state, PD state, and Death state. The survival data came from the GOG-240 test. The utility value and cost unit price were derived from a local top three hospital in 2017 or references. Sensitivity analysis was performed on the results. RESULTS The model running for 10 years showed that the addition of BEV increased the total cost by 233 974.10 yuan (503 336.67 yuan vs 269 362.57 yuan). Compared with the standard chemotherapy group, the addition of BEV increased the total utility value by 0.17 quality-adjusted life year(QALY) (0.94 QALY vs 0.77 QALY) and the ICER was 1 376 318.23 yuan/QALY. The results of one-dimensional sensitivity analysis showed that the cost of PFS, BEV and PFS of BEV+chemotherapy group were the top three parameters influencing the model. The probability sensitivity analysis results showed that the probability of incremental cost-effectiveness ratio value greater than willingness to pay(3 times GDP) was 100%. CONCLUSION The incremental cost-effectiveness ratio of the BEV combination regimen far exceeds the established WTP compared to the standard chemotherapy regimen, so considering the unit cost of BEV and the survival benefits it brings, BEV combination therapy has no cost-effectiveness.