The cost-effectiveness of cemiplimab plus chemotherapy as the first-line treatment for advanced non-small cell lung cancer

Frontiers in Pharmacology

Pharmacology

Ruijia Chen¹  Yingying Hu¹  Yufan Huang²  Xiaoxiao Chen²  Wangchun Lin²  Tingting Lu²  Zhongjie Cai² 

[1] Department of Pharmacy, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China;Department of Pharmacy, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China;

关键词: cost-effectiveness;    cemiplimab;    chemotherapy;    advanced non-small cell lung cancer;    first-line treatment;   

DOI  :  10.3389/fphar.2023.1171302

 received in 2023-02-22, accepted in 2023-07-10,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background: The EMPOWER-LUNG 3 clinical trial has shown that cemiplimab plus chemotherapy (CCT) significantly extended overall survival (OS) and progression-free survival (PFS) for patients with advanced non-small cell cancer (NSCLC) compared to placebo plus chemotherapy (PCT). However, the cost-effectiveness of this new treatment option remains unknown. Thus, we evaluated the cost-effectiveness of CCT versus (vs.) PCT as the first-line treatment for patients with advanced NSCLC from the perspective of the Chinese healthcare system.Methods: We constructed a Markov model to evaluate the cost-effectiveness of CCT as the first-line treatment for patients with advanced NSCLC. The transition probabilities were extracted from the survival data of the EMPOWER-LUNG 3 trial. The drugs’ costs were referred from national tender prices, while other model input parameters were derived from the EMPOWER-LUNG 3 trial and published literature. The outcome parameters mainly included quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis and probabilistic sensitivity analysis were performed to evaluate the robustness of the model outcomes.Results: Compared to PCT, in the CCT regimen, an additional $79,667 was spent in terms of the total cost and with an additional 0.31 QALYs, resulting in an ICER value of $253,148/QALY. Sensitivity analysis indicated that the hazard ratio (HR) of OS, the cost of cemiplimab (100 mg), and the HR of PFS, all significantly impacted the model’s results. The probability of CCT (vs. PCT) being cost-effective was 0% at a willingness-to-pay threshold of $38,201/QALYs in China. The scenario analysis showed that when the price of cemiplimab was reduced to less than $184.09/100 mg, the CCT regimen could be considered cost-effective as the first-line treatment for patients with advanced NSCLC compared to the PCT.Conclusion: In China, the CCT was not cost-effective as the first-line treatment for patients with advanced NSCLC.

【 授权许可】

Unknown   
Copyright © 2023 Lu, Huang, Cai, Lin, Chen, Chen and Hu.