Cost-effectiveness analysis of Capecitabine Plus Oxaliplatin Versus
Gemcitabine Plus Oxaliplatin as First-Line Therapy for Advanced Biliary
Tract Cancers
Abstract
Background: In the first-line treatment of BTCs, XELOX has shown
comparable clinical efficacy and safety to GEMOX, with fewer visits and
better treatment management. Our study aims to investigate the
cost-effectiveness of XELOX and GEMOX as the first-line therapy for BTCs
from the perspective of the United States healthcare systems and
provides valuable suggestions for clinical drug treatment decisions.
Methods: A Markov model was developed using the Phase 3 randomized
clinical trial (ClinicalTrials.gov number, NCT01470443) to evaluate the
cost-effectiveness of XELOX and GEMOX. Quality-adjusted life-years
(QALYs) and incremental cost-effectiveness ratios (ICERs) were used as
the primary outcomes of the model. Using univariate and probabilistic
sensitivity analyses to assess the uncertainty. Results: The QALYs for
the XELOX and GEMOX groups were 0.66 and 0.54, respectively. The
additional cost of XELOX treatment was US$493.30 in the United States
and ICER was US $4333.28/QALY, which was far below the threshold of
willingness to pay (US$50,000 /QALY). The XELOX therapy was confirmed
as a stable economic advantage by sensitivity analysis in the United
States. Conclusions: XELOX, compared with GEMOX, is a more
cost-effective treatment as the first-line treatment for advanced BTCs
from the perspective of the United States health service system.