{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:30:36Z","timestamp":1753893036943,"version":"3.41.2"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"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":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Rezvilutamide, an androgen-receptor inhibitor, has been approved by the Chinese National Medical Products Administration as a first-line treatment for high-volume metastatic hormone-sensitive prostate cancer (mHSPC). This study aims to assess the cost-effectiveness of rezvilutamide plus androgen-deprivation therapy (ADT) compared to bicalutamide plus ADT for the first-line treatment of high-volume mHSPC in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A Markov model with three health states was developed to evaluate the health and economic outcomes of first-line treatment for high-volume mHSPC. Efficacy data were sourced from the CHART trial. Quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated. To address modeling uncertainties, one-way sensitivity analysis and probabilistic sensitivity analysis were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with bicalutamide plus ADT, rezvilutamide plus ADT resulted in an additional 2.16 QALYs, with an ICER of $39,122.16\/QALY. At a willingness-to-pay (WTP) threshold of three times the gross domestic product per capita in China for 2023 ($37,256.3\/QALY), the probability of cost-effectiveness for rezvilutamide plus ADT was 30%. One-way sensitivity analysis revealed that the results were most sensitive to the cost of rezvilutamide. Scenario analysis indicated that rezvilutamide could be considered cost-effective if priced below $705.46 per cycle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>From the perspective of Chinese payers, rezvilutamide plus ADT appears to be a less cost-effective strategy compared to bicalutamide plus ADT for the first-line treatment of high-volume mHSPC in China.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1574780","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T05:23:09Z","timestamp":1748323389000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness analysis of rezvilutamide versus bicalutamide and androgen-deprivation therapy in patients with high-volume, metastatic, hormone-sensitive prostate cancer: a Markov\u2019s model-based evaluation"],"prefix":"10.3389","volume":"13","author":[{"given":"Juan","family":"Hong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohui","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyuan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuming","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Meng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihui","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"221","DOI":"10.3760\/cma.j.cn112152-20240119-00035","article-title":"Cancer incidence and mortality in China, 2022","volume":"46","author":"Zheng","year":"2024","journal-title":"Zhonghua Zhong Liu Za Zhi"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"29","DOI":"10.3760\/cma.j.cn112152-20211226-00975","article-title":"China guideline for the screening and early detection of prostate cancer (2022, Beijing)","volume":"44","author":"He","year":"2022","journal-title":"Zhonghua Zhong Liu Za Zhi"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e555","DOI":"10.1016\/S2214-109X(18)30127-X","article-title":"Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries","volume":"6","author":"Zeng","year":"2018","journal-title":"Lancet Glob Health"},{"year":"","key":"ref5"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3652","DOI":"10.1200\/JCO.23.00155","article-title":"Initial Management of Noncastrate Advanced, recurrent, or metastatic prostate Cancer: ASCO guideline update","volume":"41","author":"Virgo","year":"2023","journal-title":"J Clin Oncol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"5608","DOI":"10.7150\/jca.30731","article-title":"Risk factors for progression to castration-resistant prostate cancer in metastatic prostate cancer patients","volume":"10","author":"Lin","year":"2019","journal-title":"J Cancer"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1200\/JCO.2017.75.3657","article-title":"Chemohormonal therapy in metastatic hormone-sensitive prostate Cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial","volume":"36","author":"Kyriakopoulos","year":"2018","journal-title":"J Clin Oncol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1016\/S0140-6736(15)01037-5","article-title":"Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial","volume":"387","author":"James","year":"2016","journal-title":"Lancet"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/S1470-2045(12)70560-0","article-title":"Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial","volume":"14","author":"Gravis","year":"2013","journal-title":"Lancet Oncol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1016\/S0140-6736(00)02163-2","article-title":"Prostate Cancer Trialists\u2019 Collaborative Group. 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