Evidence map›Paper›PMID 38778261›Full record

ArticleBMC cancer2024

Cost-effectiveness of ivosidenib versus chemotherapy for previously treated IDH1-mutant advanced intrahepatic cholangiocarcinoma in Taiwan.

Kuei-An Chen, Wei-Ming Huang, Eric Yi-Ting Chen, Pei-Kuan Ho, Chen-Han Chueh, Yu-Wen Wen, Ming-Huang Chen, Nai-Jung Chiang, Yi-Wen Tsai

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Expanding the eligibility criteria for drugs in Canada's time-limited health technology assessment and temporary drug access processes will further accelerate access to new medicines.Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kuei-An Chen *Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Wei-Ming Huang *Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Eric Yi-Ting ChenInstitute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Pei-Kuan HoInstitute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Chen-Han ChuehInstitute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Yu-Wen WenClinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.
Ming-Huang ChenDepartment of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
Nai-Jung ChiangDepartment of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan. njchiang@vghtpe.gov.tw.
Yi-Wen TsaiInstitute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan. ywtsai@nycu.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInternational guidelines recommend ivosidenib followed by modified FOLFOX (mFOLFOX) for advanced intrahepatic cholangiocarcinoma (ICC) with isocitrate dehydrogenase 1 (IDH1) mutations. Taiwan National Health Insurance covers only fluorouracil/leucovorin (5-FU/LV) chemotherapy for this ICC group, and there has been no prior economic evaluation of ivosidenib. Therefore, we aimed to assess ivosidenib's cost-effectiveness in previously treated, advanced ICC-presenting IDH1 mutations compared with mFOLFOX or 5-FU/LV.

methodsA 3-state partitioned survival model was employed to assess ivosidenib's cost-effectiveness over a 10-year horizon with a 3% discount rate, setting the willingness-to-pay threshold at 3 times the 2022 GDP per capita. Efficacy data for Ivosidenib, mFOLFOX, and 5-FU/LV were sourced from the ClarIDHy, ABC06, and NIFTY trials, respectively. Ivosidenib's cost was assumed to be NT$10,402/500 mg. Primary outcomes included incremental cost-effectiveness ratios (ICERs) and net monetary benefit. Deterministic sensitivity analyses (DSA) and probabilistic sensitivity analyses (PSA) were employed to evaluate uncertainty and explore price reduction scenarios.

resultsIvosidenib exhibited ICERs of NT$6,268,528 and NT$5,670,555 compared with mFOLFOX and 5-FU/LV, respectively, both exceeding the established threshold. PSA revealed that ivosidenib was unlikely to be cost-effective, except when it was reduced to NT$4,161 and NT$5,201/500 mg when compared with mFOLFOX and 5-FU/LV, respectively. DSA underscored the significant influence of ivosidenib's cost and utility values on estimate uncertainty.

conclusionsAt NT$10,402/500 mg, ivosidenib was not cost-effective for IDH1-mutant ICC patients compared with mFOLFOX or 5-FU/LV, indicating that a 50-60% price reduction is necessary for ivosidenib to be cost-effective in this patient group.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBile Duct NeoplasmsCholangiocarcinomaCost-Benefit AnalysisFluorouracilGlycineIsocitrate DehydrogenaseLeucovorinMutationPyridinesFemaleHumansMaleMiddle AgedOrganoplatinum CompoundsTaiwanFluorouracilGlycineIDH1 protein, humanIsocitrate DehydrogenaseivosidenibLeucovorinOrganoplatinum CompoundsPyridinesAdvanced intrahepatic cholangiocarcinomaCost-effectivenessIDH1 mutationsIvosidenib

Identifiers

PMID38778261
PMCPMC11110281

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.