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\begin{document}

\title{Cost-effectiveness analysis of Capecitabine Plus Oxaliplatin Versus
Gemcitabine Plus Oxaliplatin as First-Line Therapy for Advanced Biliary
Tract Cancers}



\author[1]{Yalan Zhang}%
\author[2]{Ruijia Chen}%
\author[3]{Wencong Hong}%
\author[4]{Wentan Xu}%
\author[2]{Yingying Hu}%
\affil[1]{Second Affiliated Hospital of Fujian Medical University}%
\affil[2]{Mengchao Hepatobiliary Hospital of Fujian Medical University}%
\affil[3]{Nan’an Hospital}%
\affil[4]{Jinjiang Municipal Hospital}%


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  \date{May 24, 2024}


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\begin{abstract}
Background: In the first-line treatment of BTCs, XELOX has shown
comparable clinical efficacy and safety to GEMOX, with fewer visits and
better treatment management. Our study aims to investigate the
cost-effectiveness of XELOX and GEMOX as the first-line therapy for BTCs
from the perspective of the United States healthcare systems and
provides valuable suggestions for clinical drug treatment decisions.
Methods: A Markov model was developed using the Phase 3 randomized
clinical trial (ClinicalTrials.gov number, NCT01470443) to evaluate the
cost-effectiveness of XELOX and GEMOX. Quality-adjusted life-years
(QALYs) and incremental cost-effectiveness ratios (ICERs) were used as
the primary outcomes of the model. Using univariate and probabilistic
sensitivity analyses to assess the uncertainty. Results: The QALYs for
the XELOX and GEMOX groups were 0.66 and 0.54, respectively. The
additional cost of XELOX treatment was US\$493.30 in the United States
and ICER was US \$4333.28/QALY, which was far below the threshold of
willingness to pay (US\$50,000 /QALY). The XELOX therapy was confirmed
as a stable economic advantage by sensitivity analysis in the United
States. Conclusions: XELOX, compared with GEMOX, is a more
cost-effective treatment as the first-line treatment for advanced BTCs
from the perspective of the United States health service system.%
\end{abstract}%



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