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Comparison Between Sotorasib with Docetaxel for the Treatment of Chinese Patients with Previously Treated NSCLC with KRASG12C Mutation: A Cost-Effectiveness Analysis to Inform Drug Pricing

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Abstract

Introduction

This study sought to investigate the affordable price of sotorasib among patients with previously treated advanced KRASG12C-mutant non-small cell lung cancer (NSCLC) through a cost-effectiveness analysis from the perspectives of both the Chinese healthcare system and the patients.

Methods

We developed a Markov model spanning a 20-year time horizon with a cycle length of 21 days. Our data were derived from the CodeBreaK 200 clinical trial, supplemented with published literature, publicly available national databases, and local hospitals. The primary outcomes were the affordable prices of sotorasib which would result in the incremental cost-effectiveness ratios (ICERs) of sotorasib relative to docetaxel below the preset willing-to-pay (WTP) threshold. Sensitivity analyses were performed to evaluate the model's robustness.

Results

At the national level, from the perspective of the Chinese healthcare system and patients, the price of sotorasib should be lower than US$0.04673 and $0.03231, respectively, to make it affordable, which is equivalent to $1346 and $931 per box (120 mg × 240 pieces). At the provincial level, the price ceiling of sotorasib/mg fluctuated between $0.04084 to $0.08061 from the Chinese healthcare system’s perspective and between $0.02642 to $0.06620 from the patients’ perspective. Probabilistic sensitivity analyses revealed that, as the price of sotorasib decreased, its likelihood of being cost-effective increased.

Conclusion

Sotorasib might be a cost-effective therapy in China. The pharmaco-economic evidence generated from this study has significant implications not only for guiding the drug pricing of the upcoming sotorasib but also for determining the reimbursement ratio for its potential inclusion in the National Reimbursement Drugs List in the future.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Funding

This work and its publication, including the journal’s Rapid Service Fee was supported by the Hunan Provincial Natural Science Foundation of Science and Medicine Joint Fund (Project No. 2022J80040) and the Hunan Provincial Health Commission Project (Project No. 202213053462).

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Authors and Affiliations

  1. Department of Pharmacy, The Second **angya Hospital, Central South University, Changsha, 410000, Hunan, China

    Lidan Yi & Qiao Liu

  2. PET-CT Center, The Second **angya Hospital of Central South University, Changsha, China

    **aohui Zeng

  3. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Zhen Zhou

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  1. Lidan Yi
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  2. **aohui Zeng
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  3. Zhen Zhou
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  4. Qiao Liu
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Contributions

Qiao Liu had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Lidan Yi, **aohui Zeng and Qiao Liu: concept and design. All authors: acquisition, analysis, or interpretation of data. Lidan Yi, **aohui Zeng and Zhen Zhou: drafting of the manuscript. All authors: critical revision of the manuscript for important intellectual content. Lidan Yi and Qiao Liu: statistical analysis.

Corresponding author

Correspondence to Qiao Liu.

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Conflict of Interest

Lidan Yi, **aohui Zeng, Zhen Zhou, Qiao Liu declare they have nothing to disclose. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical Approval

The model used in this analysis was based on previously conducted studies and other economic models; no studies with human participants or animals were performed by any of the authors. Since only existing, non-identifiable data were used to develop the model, the study was deemed exempt from the approval of the Chinese Ethics Review Committee.

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Yi, L., Zeng, X., Zhou, Z. et al. Comparison Between Sotorasib with Docetaxel for the Treatment of Chinese Patients with Previously Treated NSCLC with KRASG12C Mutation: A Cost-Effectiveness Analysis to Inform Drug Pricing. Adv Ther (2024). https://doi.org/10.1007/s12325-024-02908-8

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