Cost-effectiveness analysis of toripalimab plus chemotherapy versus chemotherapy alone for advanced non-small cell lung cancer in China

Frontiers in Immunology

Immunology

Yingtao Lin¹  Yuwen Bao²  Kai Xu³  Lingli Zhang³  Mengdie Zhang³  Xin Li⁴  Chongchong Zhou⁵ 

[1] Department of Drug Clinical Trial Institution, Fujian Cancer Hospital, Fuzhou, Fujian, China;Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, China;Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, China;Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, China;Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, China;Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China;Department of Pharmaceutical Regulatory Science and Pharmacoeconomics, School of Pharmacy, Nanjing Medical University, Nanjing, China;Department of Research Management, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China;

关键词: toripalimab;    PD-1;    cost-effectiveness;    partitioned survival model;    advanced non-small cell lung cancer (advanced NSCLC);    chemothearpy;    China;   

DOI  :  10.3389/fimmu.2023.1169752

 received in 2023-02-20, accepted in 2023-05-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundToripalimab is the first domestic anti-tumor programmed death 1 antibody marketed in China. The CHOICE-01 trial (identifier: NCT 03856411) demonstrated that toripalimab plus chemotherapy can significantly improve the clinical outcomes of advanced non-small cell lung cancer (NSCLC) patients. However, whether it is cost-effective remains unknown. Given the high cost of combination therapy, a cost-effectiveness analysis of toripalimab plus chemotherapy (TC) versus chemotherapy alone (PC) for the first-line treatment of patients with advanced NSCLC is required.MethodsA partitioned survival model was adopted to predict the course of disease in advanced NSCLC patients on TC or PC from the perspective of the Chinese healthcare system over a 10-year horizon. The survival data were obtained from the CHOICE-01 clinical trial. Cost and utility values were obtained from local hospitals and kinds of literature. Based on these parameters, the incremental cost-effectiveness ratio (ICER) of TC vs. PC was measured, and one-way sensitivity analyses, probabilistic sensitivity analyses (PSA), and scenario analyses were performed to assess the robustness of the model.ResultsIn the base case, TC was associated with an incremental cost of $18510 and an incremental quality-adjusted life year (QALY) of 0.57 compared with PC, resulting in an ICER of $32237/QALY which was lower than the willingness to pay (WTP) threshold ($37654/QALY), TC was cost-effective. The health utility value of progression-free survival, the price of toripalimab, and the cost of best supportive care were factors that significantly influenced the ICER, but no change in any of them could change the model result. TC showed a 90% probability of being a cost-effective option at a WTP threshold of $37,654/QALY. In the 20 and 30-year time horizons, the results remained unchanged and TC remained cost-effective when the second-line treatment was switched to docetaxel.ConclusionAt a WTP threshold of $37,654 per QALY, TC was cost-effective compared to PC for patients with advanced NSCLC in China.

【 授权许可】

Unknown   
Copyright © 2023 Zhang, Xu, Lin, Zhou, Bao, Zhang and Li