| 要約: | In china, unresectable hepatocellular carcinoma (uhcc) poses a significant
clinical challenge, highlighting the need to assess the cost-effectiveness and
accessibility of first-line treatments. This study examined the cost-effectiveness of
sorafenib, lenvatinib, and donafenib for uhcc in china, with a focus on disparities
in quality-adjusted life years (qalys). We used a partitioned survival model for
the analysis, drawing clinical data from medical records, patient-reported outcomes,
literature, and expert consensus. Key outcomes included costs in us dollars, health
outcomes in qalys, and the incremental cost-effectiveness ratio (icer) based on a
willingness-to-pay threshold of us $37,128 (three times china's per capita gdp) per
qaly gained. Sensitivity analyses were conducted to assess robustness. We also ran
linear regression models to explore the relationship between qalys and variables
such as treatment, age, gender, weight, job status, education, income, ethnicity, and
chronic liver disease. Shapley values were used to determine the relative importance
of these factors. Sorafenib provided an additional 0.024 qalys compared to
lenvatinib, with icers of us $-176,876.12/qaly (weight >60 kg) and us $-
562,151.20/qaly (weight <60 kg). Negative icer values indicate that sorafenib is
not only more effective but also less costly compared to lenvatinib, making it a
dominant treatment option for both weight categories.
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