OBJECTIVES: To compare the cost-effectiveness of the two tyrosine kinase inhibitors (TKI), imatinib and dasatinib, in treating pediatric patients with philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) in China.

METHODS: A decision tree model combined with a 10-year Markov model was established based on the published data and real-world data. Cost-effectiveness analysis was used to calculate the increase cost-effectiveness ratio (ICER) of the two drugs. From the health system perspective, direct costs related to treatment were included in this research. One-way sensitivity analyses and probability sensitivity analysis were conducted to assess the uncertainty and result robustness. The set threshold was recommended by the World Health Organization (WHO).

RESULTS: The total costs were ￥1093254.74 and ￥1249443.83 in imatinib group and dasatinib group over the simulative course of a decade, and the total quality-adjusted life years (QALYs) were 3.08 and 5.38. Compared with the imatinib treatment group, the ICER of dasatinib treatment was around ￥68091.79/QALY, which is less than the set threshold ￥70892. Across a range of parameter estimates, there was a 50.8% chance that dasatinib is more cost-effective than imatinib.

CONCLUSIONS: Under the set threshold, which is 1 times per capita GDP of China in 2019, dasatinib with the current price has potential cost-effective advantages compared with imatinib.