ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1574780
This article is part of the Research TopicInnovative Value-Based Medicine: Lessons from China's Healthcare EvolutionView all 6 articles
A Markov model-based cost-effectiveness comparison of rezvilutamide versus bicalutamide and androgen-deprivation therapy in patients with high-volume, metastatic, hormone-sensitive prostate cancer
Provisionally accepted
- 1Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
- 2Department of Nuclear Medicine/PET Image Center, The Second Xiangya Hospital of Central South University, Changsha, China
- 3School of Pharmacy, Guangdong Medical University, Dongguan, China
- 4Department of Pharmacy, The affiliated Changsha Hospital of Xiangya School of Medicine, Changsha, China
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Objectives: Rezvilutamide, an androgen-receptor inhibitor, has been approved by the Chinese National Medical Products Administration as a first-line treatment for high-volume metastatic hormone-sensitive prostate cancer (mHSPC). This study aims to assess the cost-effectiveness of rezvilutamide plus androgen-deprivation therapy (ADT) compared to bicalutamide plus ADT for the first-line treatment of high-volume mHSPC in China.Methods: A Markov model with three health states was developed to evaluate the health and economic outcomes of first-line treatment for high-volume mHSPC. Efficacy data were sourced from the CHART trial. Quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated. To address modeling uncertainties, one-way sensitivity analysis and probabilistic sensitivity analysis were performed.Results: Compared with bicalutamide plus ADT, rezvilutamide plus ADT resulted in an additional 2.16 QALYs, with an ICER of $39,122.16 /QALY. At a willingness-to-pay (WTP) threshold of three times the gross domestic product per capita in China for 2023 ($37,256.3/QALY), the probability of cost-effectiveness for rezvilutamide plus ADT was 30%. One-way sensitivity analysis revealed that the results were most sensitive to the cost of rezvilutamide. Scenario analysis indicated that rezvilutamide could be considered cost-effective if priced below $705.46 per 80 mg.Conclusions: From the perspective of Chinese payers, rezvilutamide plus ADT appears to be a less cost-effective strategy compared to bicalutamide plus ADT for the first-line treatment of high-volume mHSPC in China.
Keywords: Cost-Effectiveness, rezvilutamide, Bicalutamide, highvolume mHSPC, Markov model
Received: 11 Feb 2025; Accepted: 30 Apr 2025.
Copyright: © 2025 Hong, Zeng, Chen, Zhou, He, Meng and Ouyang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jun Meng, Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
Lihui Ouyang, Department of Pharmacy, The affiliated Changsha Hospital of Xiangya School of Medicine, Changsha, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.