COST-EFFECTIVENESS ANALYSIS OF ENCORAFENIB IN UNTREATED BRAF V600E-MUTANT METASTATIC COLORECTAL CANCER IN CHINA
Author(s)
Lijing Yang, Bachelor1, Yingting Zeng, Bachelor2, Qing Li, Bachelor2, Shaohong Luo, Bachelor3, xiuhua weng, Doctor4;
1The School of Pharmacy,Fujian Medical University, Student, Fuzhou, China, 2The School of Pharmacy,Fujian Medical University, Fuzhou, China, 3The First Affiliated Hospital of Fujian Medical University, FUZHOU, China, 4Fujian Medical University Mengchao Hepatobiliary Hospital, Fuzhou, China
1The School of Pharmacy,Fujian Medical University, Student, Fuzhou, China, 2The School of Pharmacy,Fujian Medical University, Fuzhou, China, 3The First Affiliated Hospital of Fujian Medical University, FUZHOU, China, 4Fujian Medical University Mengchao Hepatobiliary Hospital, Fuzhou, China
OBJECTIVES: To appraise the cost-effectiveness of EC, EC plus mFOLFOX6 versus standard of care (SOC) group as first-line treatment for BRAF V600E-mutant mCRC from the Chinese payers perspective.
METHODS: A three-state partitioned survival model was developed to simulate the disease treatment pathway for patients with BRAF V600E-mutant mCRC and calculate associated treatment costs. Clinical efficacy and adverse event data were derived from the BREAKWATER trials. Given that encorafenib is not yet commercially available in China, its price was assumed to be equivalent to that of trametinib, and other drug acquisition fee were sourced from Yaozhi.com. Costs related to adverse event management, best supportive care, and end-of-life care were obtained from published literature. Primary outcome measures included total costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). The willingness-to-pay (WTP) threshold was set as $40,343.68/QALY (three times the per capita gross domestic product). Sensitivity analyses were conducted to assess model robustness and result reliability.
RESULTS: Compared with SOC, EC and EC plus mFOLFOX6 generated an extra cost of $32,146.73 and $90,012.19, along with an incremental effectiveness of 0.41 and 1.09 QALY. The resultant ICER were $77,589.95/QALY and $82,419.06/QALY, respectively. One-way sensitivity analysis demonstrated that the unit price of cetuximab and patients’ body surface area represented two major determinants influencing the result. Probability sensitivity analysis revealed that SOC displayed an overwhelming advantage with 95.43% and 99.64% probability to be cost-effective at the WTP threshold of $40,343.68/QALY.
CONCLUSIONS: Neither EC nor EC plus mFOLFOX6 was a cost-effective first-line treatment option for BRAF V600E-mutant mCRC. Generic drug substitution and price negotiations are important measures to enhance their economic efficiency.
METHODS: A three-state partitioned survival model was developed to simulate the disease treatment pathway for patients with BRAF V600E-mutant mCRC and calculate associated treatment costs. Clinical efficacy and adverse event data were derived from the BREAKWATER trials. Given that encorafenib is not yet commercially available in China, its price was assumed to be equivalent to that of trametinib, and other drug acquisition fee were sourced from Yaozhi.com. Costs related to adverse event management, best supportive care, and end-of-life care were obtained from published literature. Primary outcome measures included total costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). The willingness-to-pay (WTP) threshold was set as $40,343.68/QALY (three times the per capita gross domestic product). Sensitivity analyses were conducted to assess model robustness and result reliability.
RESULTS: Compared with SOC, EC and EC plus mFOLFOX6 generated an extra cost of $32,146.73 and $90,012.19, along with an incremental effectiveness of 0.41 and 1.09 QALY. The resultant ICER were $77,589.95/QALY and $82,419.06/QALY, respectively. One-way sensitivity analysis demonstrated that the unit price of cetuximab and patients’ body surface area represented two major determinants influencing the result. Probability sensitivity analysis revealed that SOC displayed an overwhelming advantage with 95.43% and 99.64% probability to be cost-effective at the WTP threshold of $40,343.68/QALY.
CONCLUSIONS: Neither EC nor EC plus mFOLFOX6 was a cost-effective first-line treatment option for BRAF V600E-mutant mCRC. Generic drug substitution and price negotiations are important measures to enhance their economic efficiency.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE50
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology