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Home > Vol 43, No 4 (2025) > Yang

Cost-Effectiveness of Sorafenib, Lenvatinib, and FOLFOX4 for Advanced Hepatocellular Carcinoma in China

Jian Yang, Min Zhao, Xiaolei Zhou, Mu Yan, Xuejuan Zhao, Fan Li

Abstract

Objective: Liver cancer is the third leading cause of cancer mortality in China. This study assesses the cost-effectiveness of sorafenib, lenvatinib, and FOLFOX4 in the treatment of advanced hepatocellular carcinoma (HCC) to inform clinical decision-making.
Material and Methods: We used a Markov model to simulate the progression of HCC and calculate Quality-Adjusted Life Years (QALYs) and Incremental Cost-Effectiveness Ratios (ICERs) under two scenarios. Costs were obtained from the Yaozhi Network, while transition probabilities and utilities were derived from the REFLECT, EACH, and CELESTIAL clinical trials. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to evaluate model robustness and parameter uncertainty.
Results: In Scenario A, using market-listed prices, sorafenib, and lenvatinib were found to be more cost-effective than FOLFOX4, with ICERs of $11,635.28 and $1,499.93 per QALY, respectively, both below the cost-effectiveness threshold. In Scenario B, with centralized procurement prices, sorafenib had a negative ICER of -$7,351.26 per QALY, indicating cost savings with improved outcomes, while lenvatinib had an ICER of $2,685.99 per QALY. Sensitivity analysis revealed that drug costs, utilities of disease progression, and discount rates were key determinants of ICER values.
Conclusion: Sorafenib and lenvatinib are significantly more cost-effective compared to FOLFOX4, particularly under centralized procurement pricing. These results support the inclusion of these treatments in public health policy to enhance healthcare outcomes and optimize resource allocation, thereby improving the economic and quality-of-life metrics for patients with HCC.

 

 Keywords

centralized procurement policies; cost-effectiveness analysis; hepatocellular carcinoma; markov model; sensitivity analysis

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References

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DOI: http://dx.doi.org/10.31584/jhsmr.20251153

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About The Authors

Jian Yang
Department of Pharmacy, School of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan 650500, China. Pharmacoeconomic Evaluation Department, Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan 650500, China. Department of Clinical Pharmacy, College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan 650500,
China

Min Zhao
Department of Pharmacy, School of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan 650500, China. Pharmacoeconomic Evaluation Department, Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan 650500, China. Department of Clinical Pharmacy, College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan 650500,
China

Xiaolei Zhou
Department of Governmental Affairs, Hanhui Pharmaceuticals Co., Ltd, Xuhui, Shanghai 200032,
China

Mu Yan
Department of Anesthesiology, The First Clinical Medical College, Kunming Medical University, Kunming, Yunnan 650500, China. Department of Clinical Pharmacy, College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan 650500,
China

Xuejuan Zhao
Department of Pharmacy, School of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan 650500, China. Pharmacoeconomic Evaluation Department, Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan 650500, China. Department of Clinical Pharmacy, College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan 650500,
China

Fan Li
Pharmacoeconomic Evaluation Department, Yunnan Provincial Center for Drug Policy Research, Kunming, Yunnan 650500, China. Department of Clinical Pharmacy, College of Modern Biomedical Industry, Kunming Medical University, Kunming, Yunnan 650500,
China

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Keywords COVID-19 SARS-CoV-2 Thailand Vietnam children computed tomography cross-cultural adaptation depression diabetes diabetes mellitus elderly hypertension knowledge mental health mortality prevalence quality of life reliability risk factors treatment validity
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