COST-UTILITY OF FIRST-LINE SYSTEMIC THERAPIES FOR UNRESECTABLE HEPATOCELLULAR CARCINOMA IN VIETNAM: A PRELIMINARY ANALYSIS
Author(s)
Quang Loc Duyen Vo, MSc1, Ha Thi NGUYEN, PhD2, Chanthawat Patikorn, PharmD, PhD1.
1Chulalongkorn University, Bangkok, Thailand, 2Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
1Chulalongkorn University, Bangkok, Thailand, 2Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
OBJECTIVES: This study aims to evaluate the cost-utility of first-line systemic therapies available in Vietnam for unresectable hepatocellular carcinoma (uHCC), compared with standard treatment, to support decision-making.
METHODS: A three-state partitioned survival model was developed to assess the cost-utility of lenvatinib, atezolizumab plus bevacizumab, tremelimumab plus durvalumab, and durvalumab compared with sorafenib in patients with uHCC from a societal perspective over a lifetime horizon. Clinical efficacy was derived from the IMbrave150 trial and a network meta-analysis. Cost inputs, including direct medical costs, direct non-medical costs, and indirect costs, were obtained from published literature and Vietnamese-specific cost data and standardized to 2024 Vietnamese Dong (VND). Outcomes were measured in quality-adjusted life years (QALYs). An incremental cost-effectiveness ratio (ICER) was applied to compare cost and health outcomes across treatment strategies. Univariate and probabilistic sensitivity analyses were performed to evaluate the parameter’s uncertainty.
RESULTS: Compared with sorafenib, lenvatinib, durvalumab, tremelimumab plus durvalumab, and atezolizumab plus bevacizumab yielded additional QALYs of 0.048, 0.056, 0.232, and 0.308, respectively. The ICERs were 304.2 million VND/QALY for lenvatinib, 6.65 billion VND/QALY for durvalumab, 2.87 billion VND/QALY for tremelimumab plus durvalumab and 3.12 billion VND/QALY for atezolizumab plus bevacizumab. At a willingness-to-pay threshold of one to three times Vietnamese gross domestic product (GDP) per capita in 2024, equivalent to 114-342 million VND (4,717-14,151 US Dollars), lenvatinib was cost-effective compared with sorafenib, whereas durvalumab, tremelimumab plus durvalumab, and atezolizumab plus bevacizumab were not cost-effective. Sensitivity analyses generally supported the base-case findings.
CONCLUSIONS: Preliminary findings suggest that although first-line systemic therapies may provide additional health benefits for uHCC patients, only lenvatinib was cost-effective at the current willingness-to-pay threshold in Vietnam. These early results provide evidence to inform reimbursement considerations and future patient-access strategies for systemic therapies.
METHODS: A three-state partitioned survival model was developed to assess the cost-utility of lenvatinib, atezolizumab plus bevacizumab, tremelimumab plus durvalumab, and durvalumab compared with sorafenib in patients with uHCC from a societal perspective over a lifetime horizon. Clinical efficacy was derived from the IMbrave150 trial and a network meta-analysis. Cost inputs, including direct medical costs, direct non-medical costs, and indirect costs, were obtained from published literature and Vietnamese-specific cost data and standardized to 2024 Vietnamese Dong (VND). Outcomes were measured in quality-adjusted life years (QALYs). An incremental cost-effectiveness ratio (ICER) was applied to compare cost and health outcomes across treatment strategies. Univariate and probabilistic sensitivity analyses were performed to evaluate the parameter’s uncertainty.
RESULTS: Compared with sorafenib, lenvatinib, durvalumab, tremelimumab plus durvalumab, and atezolizumab plus bevacizumab yielded additional QALYs of 0.048, 0.056, 0.232, and 0.308, respectively. The ICERs were 304.2 million VND/QALY for lenvatinib, 6.65 billion VND/QALY for durvalumab, 2.87 billion VND/QALY for tremelimumab plus durvalumab and 3.12 billion VND/QALY for atezolizumab plus bevacizumab. At a willingness-to-pay threshold of one to three times Vietnamese gross domestic product (GDP) per capita in 2024, equivalent to 114-342 million VND (4,717-14,151 US Dollars), lenvatinib was cost-effective compared with sorafenib, whereas durvalumab, tremelimumab plus durvalumab, and atezolizumab plus bevacizumab were not cost-effective. Sensitivity analyses generally supported the base-case findings.
CONCLUSIONS: Preliminary findings suggest that although first-line systemic therapies may provide additional health benefits for uHCC patients, only lenvatinib was cost-effective at the current willingness-to-pay threshold in Vietnam. These early results provide evidence to inform reimbursement considerations and future patient-access strategies for systemic therapies.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE102
Topic
Economic Evaluation
Disease
SDC: Oncology