Supplementary file 1_Value-based pricing of brensocatib for frequently exacerbating non-cystic fibrosis bronchiectasis in China: a China-adapted, FEV1-inclusive time-dependent markov analysis.docx

A prespecified structural sensitivity removed both mappings but retained the trial-observed exacerbation benefit. Costs and outcomes were discounted by 4.5% annually. The primary willingness-to-pay (WTP) threshold was CNY 200,000 per quality-adjusted life-year (QALY); uncertainty was examined with a paired 10,000-draw probabilistic sensitivity analysis (PSA).</p>Results<p>At an illustrative price of CNY 120,000/year, the FEV₁-inclusive base case estimated an incremental cost of CNY 551,543, gains of 0.2761 QALYs and 0.3432 discounted life-years, and 0.57 fewer lifetime exacerbations.

These results corresponded to an incremental cost-effectiveness ratio of CNY 1,997,665/QALY and P* of CNY 11,692/year. Drug acquisition accounted for almost all of the incremental cost. The PSA median P* was CNY 11,611/year (95% simulation interval CNY 4,145–19,324), and none of 10,000 simulations was cost-effective at CNY 120,000/year for WTP thresholds up to CNY 300,000/QALY.

Estimates changed little when China-specific demographic and exacerbation inputs were varied. In contrast, removing the FEV₁-linked pathway reduced P* to CNY 990/year, while assuming persistent efficacy after attrition increased it to CNY 24,432/year.</p>Conclusion<p>With inputs localised wherever credible Chinese evidence was available, the FEV₁-inclusive base case estimated P* at CNY 11,692/year for a WTP of CNY 200,000/QALY.

The broad pricing implication was stable, although the exact estimate depended chiefly on the durability and downstream consequences of the 52-week FEV₁ difference. Both the base case and the key structural sensitivity remained far below the illustrative annual price of CNY 120,000.</p>