{
    "abstract": "Olaparib, an inhibitor of poly (ADP-ribose) polymerase (PARP), has demonstrated promising outcomes in treating HER2-negative early-stage breast cancer with BRCA mutations. However, a comprehensive evaluation of its cost-effectiveness in the context of the United States and China has yet to be undertaken. This study seeks to fill this research void by performing a thorough cost-utility analysis.\nThis investigation takes as its foundation the findings from the OlympiA trial. We obtained survival curves from this trial and used the Weibull distribution function to calculate transition probabilities. Relevant literature provided the necessary data on costs, utility values, and discount rates applicable to both the United States and China. We utilized TreeAge software to construct Markov models for each country, simulating the progression of early-stage breast cancer. These models underwent extensive examination through multi-way analysis, cost-utility analysis, Monte Carlo simulations, one-way and two-way sensitivity analyses, as well as probabilistic sensitivity analysis.\nThe cost-utility analysis of the Chinese Markov model revealed that the total expenditure for the Olaparib cohort amounted to 384,274.75 RMB, generating 6.41 QALYs. Conversely, the placebo group incurred a total cost of 60,264.10 RMB, resulting in 6.34 QALYs. The Incremental Cost-Utility Ratio (ICUR) between the two cohorts stood at 5,007,332.36 RMB/QALY, which is significantly higher than thrice the Gross Domestic Product (GDP) per capita of China in 2022, set at 257,094 RMB. As for the U.S. model, the Olaparib group had a total expenditure of 245,604.01 USD, yielding 7.53 QALYs, while the placebo cohort had a total cost of 93,019.92 USD, generating 7.45 QALYs. The ICUR for the two groups was calculated at 1,891,974.19 USD/QALY, substantially surpassing the U.S. Willingness-To-Pay (WTP) threshold of 150,000 USD/QALY.\nWhen evaluated in the context of healthcare economics in both China and the United States, the implementation of an Olaparib-based treatment strategy for early-stage HER2-negative breast cancer with BRCA mutations does not present a cost-effective solution in either nation.",
    "authors": [
        {
            "affiliation": "Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.",
            "firstname": "Chenxia",
            "initials": "C",
            "lastname": "Xu"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134, Gulou District, Fuzhou, China.",
            "firstname": "Jie",
            "initials": "J",
            "lastname": "Zhuang"
        },
        {
            "affiliation": "The School of Pharmacy, Fujian Medical University, Fuzhou, China.",
            "firstname": "Jianrong",
            "initials": "J",
            "lastname": "Shen"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134, Gulou District, Fuzhou, China.",
            "firstname": "Hong",
            "initials": "H",
            "lastname": "Sun"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134, Gulou District, Fuzhou, China. jiaqincai@163.com.",
            "firstname": "Jiaqin",
            "initials": "J",
            "lastname": "Cai"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, No. 134, Gulou District, Fuzhou, China. xxwei0321@outlook.com.",
            "firstname": "Xiaoxia",
            "initials": "X",
            "lastname": "Wei"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s12962-025-00617-9",
    "journal": "Cost effectiveness and resource allocation : C/E",
    "keywords": [
        "BRCA1/2 gene",
        "Cost-utility analysis",
        "Early breast cancer",
        "Markov model",
        "Olaparib"
    ],
    "methods": null,
    "publication_date": "2025-04-14",
    "pubmed_id": "40223109\n34778188\n36034834\n36034977\n34081848\n28407996\n20733129\n27654970\n33634066\n33959007\n33176759\n36386213\n34256965\n35774581\n36564566\n38170520\n39799326",
    "results": "The cost-utility analysis of the Chinese Markov model revealed that the total expenditure for the Olaparib cohort amounted to 384,274.75 RMB, generating 6.41 QALYs. Conversely, the placebo group incurred a total cost of 60,264.10 RMB, resulting in 6.34 QALYs. The Incremental Cost-Utility Ratio (ICUR) between the two cohorts stood at 5,007,332.36 RMB/QALY, which is significantly higher than thrice the Gross Domestic Product (GDP) per capita of China in 2022, set at 257,094 RMB. As for the U.S. model, the Olaparib group had a total expenditure of 245,604.01 USD, yielding 7.53 QALYs, while the placebo cohort had a total cost of 93,019.92 USD, generating 7.45 QALYs. The ICUR for the two groups was calculated at 1,891,974.19 USD/QALY, substantially surpassing the U.S. Willingness-To-Pay (WTP) threshold of 150,000 USD/QALY.",
    "title": "Cost-utility analysis of olaparib assisted targeted therapy for BRCA mutation HER2-negative early breast cancer in China and in the United States.",
    "xml": "<Element 'PubmedArticle' at 0x788505d88fe0>"
}