Figure 1.
The model structure illustrating the five first-line strategies for treating mRCC.
Figure 2.
The Weibull plots of (A) progression-free survival and (B) overall survival.
Table 1.
The parameters of the Weibull curves fitted to the interferon-alfa Kaplan-Meier survival data from four pivotal clinical trials.
Table 2.
HR and probabilities of SAEs.
Table 3.
Base-Case Cost Estimates ($, year 2011 values) and Utilities.
Table 4.
The base-case results for the five first-line therapies.
Figure 3.
The cost-effectiveness of first-line strategies for mRCC patients.
(A) without the SPAP; (B) with the SPAP. The x-axis indicates the discounted lifetime quality-adjusted life-years (QALYs) for each strategy, and the y-axis indicates the total discounted lifetime costs (in US dollars). The oblique line connects interleukin-2 and the most cost-effective strategies; strategies above the straight lines were dominated or extended dominated. In the cost-effective plane, the values of the most incremental cost-effectiveness ratios (ICER) are depicted.
Figure 4.
A tornado diagram representing the net health benefit (in QALYs, with WTP = $13,290).
The diagram determined by a one-way sensitivity analysis of sunitinib vs. interleukin-2 for mRCC. The vertical line represents the base-case value for the net health benefit with WTP = $13,290. PFS: progression-free survival; OS: overall survival; HR: hazard ratio. The results from the one-way sensitivity analysis indicated that the most influential factor in the model was the 95% CI for the survival HR comparing sunitinib and interferon-alfa.
Figure 5.
The probabilistic results of the incremental cost-effectiveness differences.
The comparisons were conducted between sunitinib and (A) interferon-alfa, (B) bevacizumab plus interferon-alfa, (C) interleukin-2 and (D) interleukin-2 plus interferon-alfa for a cohort of 1,000 mRCC patients with or without the SPAP. The y-axis represents the incremental costs. The x-axis represents the incremental quality-adjusted life years (QALYs) gained. The ellipses surround 95% of the estimates. The dots found below the ICER threshold (the oblique lines) reflect simulations in which the cost per additional QALY gained with sunitinib was below the ICER threshold.
Figure 6.
The cost-effectiveness acceptability curves for the five first-line strategies.
(A) without the SPAP; (B) with the SPAP. The y-axis indicates the probability that a strategy is cost-effective across the willingness to pay per QALY gained (x-axis). The bold vertical dashed line represent the thresholds for China.
Table 5.
The cost-effective probabilities of five alternative strategies for 32 Chinese provinces with SPAP.*