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PD-1 ИНХИБИТОРИ В КОМБИНАЦИЯ С VEGF ИНХИБИТОРИ ЗА ЛЕЧЕНИЕ НА ПАЦИЕНТИ С МЕТАСТАТИЧЕН ХЕПАТОЦЕЛУЛАРЕН КАРЦИНОМ - ИКОНОМИЧЕСКИ АНАЛИЗ (Bulgarian)

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  • Additional Information
    • Alternate Title:
      PD-1 INHIBITORS IN COMBINATION WITH VEGF WITH INHIBITORS FOR TREATMENT OF PATIENTS WITH METASTATIC HEPATOCELLULAR CARCINOMA: AN ECONOMIC ANALYSIS. (English)
    • Abstract:
      The aim of the study was to model local cost-benefit data of alternative health technologies for the treatment of patients with metastatic hepatocellular carcinoma (mHCC). The input data to the model were the measured and evaluated clinical endpoints in the randomized multicenter clinical trial IMbrave 150. Modeling data for future health benefits and costs after the end of clinical trials using the Markov model with two health states and one absorbing state took place. Input data in the model were the primary and secondary endpoints in randomized multicenter trials identified and measured as overall survival, progression-free survival, level of objective response, time to disease progression, response duration, and adverse events. The time horizon of the model was lifetime. Costs and benefits were discounted at 3.5% per annum. The chosen perspective was the point of view of the payer. The modeling was performed using the Tree Age Pro Healthcare software product. The conducted cost/effectiveness analysis included calculation of the incremental ratio of the additional costs and the additional health benefits of the studied alternative therapies. Deterministic and probabilistic sensitivity analyses were used to assess uncertainty. In conclusion, atezolizumab in combination with bevacizumab is not a cost-effective treatment compared to sorafenib despite the demonstrated therapeutic superiority due to the very high cost of a therapeutic course. A probabilistic sensitivity analysis revealed an 18% chance that atezolizumab/bevacizumab was a costeffective therapy compared to sorafenib. To achieve the cost-effectiveness threshold, the marketing authorization holder of atezolizumab and bevacizumab needs to reduce the cost of a therapeutic course by at least 27%. [ABSTRACT FROM AUTHOR]
    • Abstract:
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