{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:28:35Z","timestamp":1753892915745,"version":"3.41.2"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"Background<\/jats:title>Medulloblastoma<\/jats:italic> is the most common malignant brain tumor of childhood, accounting for 6 to 7 percent of all childhood CNS tumors. The purpose of this study was to evaluate the economic efficacy of a bevacizumab combined with temozolomide<\/jats:italic> + irinotecan regimen for the treatment of recurrent pediatric medulloblastoma<\/jats:italic> in China.<\/jats:p><\/jats:sec>Methods<\/jats:title>The data analyzed were from a randomized phase II screening trial that showed an improved survival benefit in child patients with recurrent medulloblastoma<\/jats:italic> treated with a T+I+B combination regimen. A Markov model is constructed to estimate the incremental cost\u2013effectiveness ratio (ICER) from the perspective of Chinese society. The uncertainty in the model is solved by one-way certainty and probabilistic sensitivity analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>Our base case analysis showed that the total costs of treatment increased from $8,786.403 to $27,603.420 with the combination bevacizumab vs. the two-agent chemotherapy regimen. Treatment with T+I+B combination therapy was associated with an increase in effectiveness of 0.280 QALYs from 0.867 to 1.147 QALYs T+I regimen. The incremental cost-effectiveness ratio was $67,203.632\/QALY, which exceeded our pre-specified willingness-to-pay threshold ($38,136.26\/QALY). Cost changes associated with grade 3\u20134 AE management, tests used, or hospitalization costs had little effect on the ICER values predicted by sensitivity analysis.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Taken together, the results of this study suggest that the combination of bevacizumab with temozolomide and irinotecan is not a cost-effective option from the perspective of Chinese payers as a first-line treatment option for children with recurrent medulloblastoma<\/jats:italic> in China.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.914536","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T06:24:08Z","timestamp":1654151048000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost-Effectiveness Analysis of a Three-Drug Regimen Containing Bevacizumab for the Treatment of Recurrent Pediatric Medulloblastoma in China: Based on a COG Randomized Phase II Screening Trial"],"prefix":"10.3389","volume":"10","author":[{"given":"Zhaoyan","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangyuan","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"iv1","DOI":"10.1093\/neuonc\/noy131","article-title":"Statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011-2015","volume":"20","author":"Ostrom","year":"2018","journal-title":"Neuro Oncol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1159\/000113110","article-title":"Epidemiology of nervous system tumors in children: a survey of 1,485 cases in Beijing 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Cancer."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2738","DOI":"10.1158\/2159-8290.CD-21-0331","article-title":"Efficacy, safety, and biomarker analysis of combined PD-L1 (atezolizumab) and VEGF (bevacizumab) blockade in advanced malignant peritoneal mesothelioma","volume":"11","author":"Raghav","year":"2021","journal-title":"Cancer Discov."}],"container-title":["Frontiers in Public 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