British journal of clinical pharmacology · 2025
Golidocitinib and chidamide for refractory or relapsed peripheral T-cell lymphoma: A preliminary cost-effectiveness analysis in China.
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Jing Tianyu, Du Wenwen, Tan Yujie, Zha Jingkai, Shi Kefan, Xu Wei
Аннотация
AIMS: To evaluate the clinical efficacy and cost-effectiveness of golidocitinib, a novel JAK1 inhibitor, versus chidamide, a histone deacetylase inhibitor, for relapsed/refractory peripheral T-cell lymphoma (r/rPTCL) in the Chinese healthcare system, providing preliminary comparative evidence for these targeted therapies in the absence of head - to - head trials.
METHODS: A matching-adjusted indirect comparison (MAIC) harmonized baseline characteristics between golidocitinib (manufacturer-provided JACKPOT8 trial individual patient data) and chidamide (aggregated trial data). A partitioned survival model adopted the Chinese healthcare system perspective, with drug costs modelled using time-to-discontinuation to reflect persistence. Outcomes included lifetime costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) against China's willingness-to-pay (WTP) threshold ($13455.00/QALY). Robustness was tested via scenario analyses (10-year horizon, progression-free survival-based costing), deterministic sensitivity analysis and probabilistic Monte Carlo simulations.
RESULTS: Post-MAIC, golidocitinib significantly improved median progression-free survival (5.6 vs 2.1 months, hazard ratio [HR] = 0.502, 95% confidence interval [CI] 0.348-0.724, P < .001) but not overall survival (median NR vs 21.4 months, HR = 0.846, 95% CI 0.549-1.302, P = .428) vs chidamide. Base-case analysis showed golidocitinib incurred higher costs ($46702.13 vs $37219.44) but gained 1.35 QALYs, yielding an ICER of $7006.15/QALY (95% CI $4140.94-10355.49), below China's threshold. All sensitivity analyses supported base-case conclusions.
CONCLUSIONS: Golidocitinib demonstrates potential cost-effectiveness versus chidamide for r/rPTCL in China. While definitive conclusions await head-to-head trials, these MAIC-adjusted results provide preliminary evidence for resource allocation decisions.
METHODS: A matching-adjusted indirect comparison (MAIC) harmonized baseline characteristics between golidocitinib (manufacturer-provided JACKPOT8 trial individual patient data) and chidamide (aggregated trial data). A partitioned survival model adopted the Chinese healthcare system perspective, with drug costs modelled using time-to-discontinuation to reflect persistence. Outcomes included lifetime costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) against China's willingness-to-pay (WTP) threshold ($13455.00/QALY). Robustness was tested via scenario analyses (10-year horizon, progression-free survival-based costing), deterministic sensitivity analysis and probabilistic Monte Carlo simulations.
RESULTS: Post-MAIC, golidocitinib significantly improved median progression-free survival (5.6 vs 2.1 months, hazard ratio [HR] = 0.502, 95% confidence interval [CI] 0.348-0.724, P < .001) but not overall survival (median NR vs 21.4 months, HR = 0.846, 95% CI 0.549-1.302, P = .428) vs chidamide. Base-case analysis showed golidocitinib incurred higher costs ($46702.13 vs $37219.44) but gained 1.35 QALYs, yielding an ICER of $7006.15/QALY (95% CI $4140.94-10355.49), below China's threshold. All sensitivity analyses supported base-case conclusions.
CONCLUSIONS: Golidocitinib demonstrates potential cost-effectiveness versus chidamide for r/rPTCL in China. While definitive conclusions await head-to-head trials, these MAIC-adjusted results provide preliminary evidence for resource allocation decisions.